Azathioprine Several skin conditions are associated with sleep disorders and illnesses, including atopic dermatitis (AD) and psoriasis, primarily due to severe itching and pruritus.
What is atopic dermatitis?
Atopic dermatitis, also known as atopic eczema, is a chronic skin inflammation characterized by redness, itching, swelling, and cracking of the skin. This is a form of dermatitis that causes clear fluid to thicken in the affected area. About 20% of people will be affected by atopic dermatitis in their lifetime, and it is more common in young children and slightly more common in women. The condition may begin in childhood and manifest itself in different parts of the body as the child grows. In adults, the hands and feet are most commonly affected. Scratching the affected area can worsen the condition and increase the risk of skin infection. The cause of atopic dermatitis is not fully understood, but is believed to involve genetics, immune dysfunction, environmental factors, and skin permeability issues. The disease is not contagious and can be diagnosed based on symptoms, signs and family history.
What is psoriasis?
Psoriasis is a chronic autoimmune disease that affects the skin, causing red, dry, itchy and scaly patches. Its severity can range from localized patches to widespread coverage throughout the body. Injury to the skin can trigger psoriasis in that area, known as Kobner's phenomenon. There are five main types of psoriasis, including plaque psoriasis (the most common), guttate psoriasis, inverse psoriasis, pustular psoriasis, and erythrodermic psoriasis. Each type has different characteristics, such as plaque-like psoriasis, which has red spots with white scales, and guttate psoriasis, which has drop-shaped lesions. Psoriasis can also affect nails, causing dimpling or color changes. It is thought to be a genetic disorder triggered by environmental factors, and symptoms tend to worsen in the winter or after the use of certain medications. Infections and stress can also cause flare-ups. The immune system plays a role in psoriasis by attacking skin cells. Diagnosis is based on signs and symptoms.
In an article, "Dermatology Sleep Disorders—A Comprehensive Review," researchers sought to compile data to provide an overview of dermatology-related sleep disorders and certain dermatology medications that may cause sleep disorders, citing sleep disorders or injuries associated with dermatology. There are suspicious bidirectional influences.
Researchers point out that psychological problems may trigger certain skin diseases, such as AD, psoriasis or urticaria. They also note that while insomnia may be a result of worsening conditions, it may also be a cause.
The review also highlights the harmful effects of sleep deprivation on the body's immune system, leading to the production and release of inflammatory cytokines, leading to impaired skin barrier function, infections and some skin diseases such as non-healing ulcers. They found that certain diseases, such as psoriasis, affect heat regulation by making it more difficult for the body's ability to dissipate heat.
In their study, several skin conditions were linked to sleep disorders and illnesses, including:
- atopic dermatitis
- chronic urticaria
- Infect
- scratch/itch
- psoriasis
They found that 47% to 80% of children with AD and 33% to 90% of adults suffer from sleep disorders such as insomnia, particularly difficulty falling and staying asleep.
Certain drugs such as
- azathioprine,
- cyclosporine and
- dupilumab
Not only can AD lesions be reduced, but itching can also be reduced, thereby significantly reducing sleep disorders.
Problems with skin temperature regulation are common in people with psoriatic arthritis (PsA) and psoriasis. Additionally, they are both associated with higher rates of fatigue, lower quality of life, higher rates of psychological problems, and altered sleep compared with the general population. One study they cited found that 67% of people with psoriatic arthritis and 52% of people with psoriasis experienced sleep disturbances that resulted in daytime fatigue.
It is reported that more than 50% of patients with chronic spontaneous urticaria have sleep disorders, and these patients also have higher psychological status. Researchers have found that high doses of antihistamines can improve sleep patterns.
Infections that cause itching at night, as well as the itching itself, can also lead to sleep disturbances. Factors such as skin barrier function, transepidermal water loss, and body temperature are all related to nocturnal itching.
Among others, they also identified common sleep disorders associated with skin diseases:
- narcolepsy
- obstructive sleep apnea
- parasomnia
Sleep accounts for about one-third of a person's life. Skin conditions that cause sleep deprivation may be temporary, long-term, and/or relapsing, and may lead to psychological complications. Treating the underlying skin condition can help treat the sleep disorder, and vice versa. After understanding the harmful effects of sleep disorders, clinicians need to consider sleep disorders as important comorbidities of dermatology and treat them accordingly to improve the quality of life of dermatology patients. Sleep quality and duration can be a measure of quality of life for patients with chronic skin diseases. Maintaining a proper sleep cycle can help patients better control their behavior during the day. Dermatologists should also focus on specific medical history when evaluating patients with chronic skin conditions, and treatment should be directed toward managing nighttime sleep quality.
