Association of female sex with increased risk of sleep disturbance in adult patients with moderate to severe psoriasis: a Chinese cross-sectional study

Abstract

Objective: Up to 85.3% of patients with psoriasis experience sleep disturbance (SD). However, SD has not been characterized in Chinese patients with psoriasis, and the factors that affect SD among adult patients with psoriasis remain unclear. This study was performed to examine the risk of SD in patients with psoriasis compared with a control group of healthy individuals and to identify factors contributing to SD in patients with psoriasis. Methods: This was a cross-sectional, questionnaire-based, case-control study involving 142 adult participants with psoriasis and 142 healthy controls. The Pittsburgh Sleep Quality Index (PSQI) was administered to assess SD. Mild psoriasis was defined by Psoriasis Area and Severity Index (PASI) and body surface area (BSA) cut-offs of <10, and mild to severe psoriasis was determined by PASI and BSA cut-offs of ≥10. Results: The prevalence of SD (PSQI score of ≥6) was 47.9% in adult patients with psoriasis. The mean PSQI score in patients with psoriasis was 6.1 ± 3.7, which was higher than that in the control group (4.9 ± 2.5, P < 0.001). The risk of SD in the psoriasis group was 1.669 times higher (adjusted odds ratio, 1.669; 95% confidence interval, 1.008–2.761; P = 0.046) than that in the healthy group. Female sex (adjusted odds ratio, 4.130; 95% confidence interval, 1.306–13.058; P = 0.016) was significantly associated with an increased risk of SD in patients with moderate to severe psoriasis, whereas there were no significant factors affecting the risk of SD in patients with mild psoriasis. Conclusions: Patients with psoriasis were more likely than healthy controls to develop SD. In patients with moderate to severe psoriasis, but not in those with mild psoriasis, female sex was associated with a higher likelihood of SD.