Inadequate sleep not only exacerbates stress but also intensifies skin symptoms, creating a detrimental cycle. Individuals with skin conditions such as atopic dermatitis, psoriasis, and acne often grapple with symptoms like itchiness and tenderness, making it challenging to achieve a restful night’s sleep. Unfortunately, the consequences of poor sleep extend beyond nighttime discomfort, impacting overall physical well-being and work performance.
A recent comprehensive study conducted across 20 countries and encompassing over 17,000 respondents sheds light on the pervasive issue. The findings, presented at the European Academy of Dermatology and Venereology (EADV) Congress 2023 on October 13, reveal a striking statistic: more than 40 percent of individuals with skin diseases reported experiencing sleep disturbances. This substantial portion of the surveyed population, comprising over 7,000 individuals, highlighted the profound impact of skin conditions on their ability to attain quality sleep, ultimately affecting their daily functioning and professional performance. The imminent publication of this research promises to contribute valuable insights into the intricate relationship between skin health, sleep quality, and overall well-being.
“Nearly half of the patients with skin diseases suffered from sleep disturbances due mainly to itching in 60 percent of cases and burning or tingling sensations in 17 percent of cases,” said lead author Charles Taieb, MD. He is research director of European Market Maintenance Assessment, which is a private company that implements patient-oriented projects.
He added, “The study showed that these sleep problems had a wider impact on patients’ quality of life. In fact, almost half [49 percent] of patients with skin disease reported a drop in productivity at work due to sleep issues.”
Poor Sleep Makes Coping Fatigue When Awake Difficult
Dr. Taieb and his research team observed that over 80% of the participants in their study faced periods of drowsiness throughout the day. Similarly, an equivalent proportion reported experiencing fatigue immediately upon waking up. Approximately 70% of respondents mentioned persistent yawning, while 58% indicated tingling sensations in their eyes. Furthermore, nearly three-quarters of the participants displayed reduced concentration.
These manifestations of sleep disruption were significantly more prevalent among individuals with skin diseases compared to a control group of nearly 33,000 participants without such conditions. In the non-disease group, less than 20% reported diminished work productivity resulting from sleep-related issues. Moreover, all other symptoms related to insufficient sleep and fatigue were experienced 10 to 20 percent less frequently in the non-disease group. This underscores the impact of skin diseases on sleep patterns and highlights the importance of addressing these issues within this specific population.
“The results suggest that we may be underestimating the potential impact on people’s quality of life from some of these skin conditions,” Albert Chiou, MD, said. He is an associate professor of dermatology at Stanford Health Care in California and he was not part of the research done. “Clearly, symptoms are spilling over into their sleep and contributing to a high degree of sleep disturbance.”
The study involved individuals with an average age nearing 40, comprising a participant pool with a distribution of more than 42 percent males and over 57 percent females. This demographic was surveyed as part of the expansive ALL project, which seeks to gather comprehensive data on skin diseases and various skin types at a global level.
Among the survey respondents, a predominant number of 7,524 individuals reported having acne, followed by 4,874 individuals indicating atopic dermatitis–eczema, and 2,237 individuals reporting psoriasis. Additionally, a noteworthy 1,700 participants reported chronic hand eczema, while 937 individuals disclosed having rosacea. The remaining respondents reported various other skin diseases, contributing to the diverse dataset collected through this initiative.
Stress Brings about Symptoms that, In Turn, Aggravate Stress
Anthony Rossi, MD, a dermatologist associated with Memorial Sloan Kettering Cancer Center in New York City, who was not involved in the recent study, highlights that itchiness, particularly in individuals with atopic dermatitis, is a well-established factor contributing to sleep disruption.
“Children and adults who have itch from skin disease often say that they wake scratching or are not able to have restful sleep,” Dr. Rossi stated.
He proposes that insufficient sleep may intensify stress, consequently aggravating symptoms and resulting in increased nighttime scratching.
Breaking the Vicious Cycle Via Treatment
Attending to the fundamental condition is crucial for disrupting the ongoing cycle. Dr. Chiou underscores the significance of collaborating with a dermatologist to access effective treatments capable of not only alleviating symptoms but also suppressing the disease itself.
Dr. Chiou actively participated in research that scrutinized the impact of utilizing the atopic dermatitis medication dupilumab (Dupixent) on sleep quality among 188 patients. The findings, documented in the August 2023 issue of the British Journal of Dermatology, revealed a noteworthy enhancement in self-reported sleep quality among patients administered with the medication, as opposed to those receiving a placebo. This improvement was closely correlated with the amelioration of the underlying skin condition. Therefore, addressing the root cause not only contributes to alleviating symptoms but also positively influences associated factors such as sleep quality.
“I think this is just one example of how potentially controlling an underlying, symptomatic skin condition can directly improve the negative impact of the skin condition on sleep,” Chiou said.
Good Sleep Habits May be Helpful
Giving greater consideration to sleep habits could potentially contribute to enhancing the well-being and daily experiences of individuals grappling with skin conditions.
“One can create better sleep hygiene in general by setting times to go to bed,” Rossi said. “Also, creating a very restful and serene environment devoid of stimuli or electronics will allow for a better night’s sleep.”
The study’s results had emphasized the crucial importance of identifying and managing sleep disturbances early on. Researchers suggest that in the future, healthcare providers should actively engage with their patients to routinely address and monitor sleep-related concerns.
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