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What Keeps People With Psoriasis Up at Night? Anxiety, Depression, and Itchy Skin

Posted on March 04, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Aminah Wali, Ph.D.

  • Itchiness, anxiety, and depression lead to poor sleep quality for people living with psoriasis, according to a new study.
  • About half of the people with psoriasis in the study get fewer hours of sleep than is recommended by health experts.
  • Researchers concluded that psoriasis needs to be treated holistically, with doctors looking at its physical, emotional, and mental impacts on people with the condition.

Nearly 60 percent of adults living with psoriasis suffered sleep disturbances in a recent research study. About 54 percent of people with psoriasis in the study got less than seven hours of sleep per night, the doctor-recommended minimum. While the itchiness that comes with psoriasis — called pruritus — was a major cause of sleep loss, researchers found that anxiety and depression were even higher predictors of sleep problems.

The takeaway, according to the research team, is that people living with psoriasis may need better treatment to keep their itchiness in check — as well as therapies aimed at reducing anxiety and depression.

The study was published this past January in the Journal of the European Academy of Dermatology and Venereology.

Learn more about itching, insomnia, and mental health conditions with psoriasis, including causes and treatments.

The Health Risks of Poor Sleep

Psoriasis is a chronic inflammatory skin condition that affects up to 3 percent of the worldwide population. Sleep disturbances are common among people living with psoriasis, and not getting enough sleep has health consequences. It can lead to fatigue, irritability, and trouble focusing. What’s more, “Regular poor sleep puts you at risk of serious medical conditions, including obesity, coronary heart disease, and diabetes — and it shortens your life expectancy,” according to the NHS.

Past research has found links between psoriasis and sleep problems, but those studies have been more limited in scope, according to the research team. This new study looked at more than 330 people with psoriasis, along with 120 people without psoriasis. The goal was to see how factors such as age and sex/gender — as well as psoriasis symptoms and other health issues — could affect sleep.

To that end, researchers gathered data about the participants and conducted tests to measure symptoms of anxiety, depression, severity of itchiness from psoriasis, and sleep disruption.

Worse Itching Means Worse Sleep

Overall, researchers found that 59 percent of participants with psoriasis reported problems sleeping, compared to 34 percent of those without psoriasis. The study also found that people with psoriasis got a median of six hours sleep per night versus seven hours for those without psoriasis. The Centers for Disease Control and Prevention (CDC) recommends adults get at least seven hours of sleep each night to maintain good health.

Perhaps unsurprisingly, researchers found that people living with psoriasis who didn’t experience itching slept better than those who had strong or very strong itching. People whose itching flared up at night had the worst sleep quality.

Anxiety and Depression Are Major Sleep Disturbers

Although itching significantly impacted people’s sleep quality, the researchers found that anxiety and depression levels were the strongest predictors of sleep difficulties.

Digging deeper into the findings, researchers found that females were more likely to have sleep problems than males — and that females with psoriasis had higher levels of anxiety than males with the condition. The reason for this, according to the research team: “Female patients suffer more psoriasis-related psychological burden and distress, due to being more vulnerable to stigmatization, which may further lead to sleep disturbance.”

Psoriasis Needs To Be Treated Holistically

The researchers concluded that people living with psoriasis can benefit from treatments that address itching — as well as treatments for symptoms related to mental and emotional health. “Providing complementary psychotherapy aimed at reducing anxiety, depression and psychological distress may help to improve sleep in patients with psoriasis,” they wrote.

This conclusion aligns with what other health care experts have said about treating psoriasis. Last year, professors at the 30th European Association of Dermatology and Venereology Congress underscored a holistic approach in caring for people with psoriasis.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Aminah Wali, Ph.D. received her doctorate in genetics and molecular biology from the University of North Carolina at Chapel Hill. Learn more about her here.

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