Abstract
Psoriasis is a chronic, autoimmune skin disease affecting about 2–4% of the worldwide population. It is now perceived as a systemic disease because of the complex pathogenesis and multiple comorbidities. It leads to decreased quality of life and productivity of patients. Nowadays, sleep disorders are investigated as well in relation to psoriasis as another possible comorbidity. This review focuses on possible negative effects of sleep deprivation, decreased quality of life, and psychosocial status in patients with psoriasis and highlights their mutual, complex relationship of divergent consequences. The relationship between sleep disorders and psychosocial status in patients with psoriasis is bidirectional and resembles a vicious circle, one abnormality triggering the other. Sleep disorders additionally increase the risk of metabolic and psychiatric diseases in psoriatic patients who are already at increased risk of developing such disorders. There should be measures taken to screen patients with psoriasis for sleep disorders in order to diagnose early and treat.
Highlights
Sleep is an essential physiological process that is characterized by altered consciousness and changes in mind and body organ functions in a cyclic manner [1, 2]
On the one hand, increased activation of the HPA axis results in sleeplessness symptoms; on the other hand, sleep disturbances act due to promoting the activity of the same axis [19]. It results in increased secretion of cortisol and pro-inflammatory cytokines, e.g., interleukin 6 (IL-6) and tumor necrosis factor alpha, which negatively affect immune and autonomic nervous system function, leading to impairment of cognitive function and change in pain perception [4, 28]
We proved that patients with psoriasis had worse sleep quality than people without skin diseases
Summary
Sleep is an essential physiological process that is characterized by altered consciousness and changes in mind and body organ functions in a cyclic manner [1, 2]. Psoriasis is one of the most common dermatological diseases in clinical practice. Nowadays, it is treated as a skin-related problem, but more as a disorder characterized by autoimmune and inflammatory processes affecting the body’s organs and accompanied by multiple comorbidities (Figure 1) [5, 6]. Sleep and quality of life, along with psychosocial aspects in patients with psoriasis are bonded together through a network of mutual dependencies, one affecting the other bidirectionally. This review aims to show numerous possible interactions between these issues in this particular group of patients and highlight the problem of multifactorial influence and reasons for sleep and psychosocial disturbances. Available literature data suggest more frequent occurrence of insomnia, obstructive sleep apnea syndrome (OSAS), and restless leg syndrome (RLS) in patients with
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