Zaburzenia snu u chorych na łuszczycowe zapalenie stawów i łuszczycę
Data nadesłania: 18-08-2018
Data ostatniej rewizji: 09-09-2018
Data akceptacji: 14-09-2018
Data publikacji online: 31-10-2018
Data publikacji: 31-10-2018
Reumatologia 2018;56(5):301-306
To assess and measure occurrence of sleep disorders in patients with psoriatic arthritis (PsA) and psoriasis (Ps).

Material and methods:
The study included 62 patients with psoriatic arthritis and 52 patients with psoriasis. The measurement of sleep quality was conducted using the Pittsburgh Sleep Quality Index (PSQI), the evaluation of fatigue by the fatigue subscale of the FACIT-F questionnaire and the patient’s quality of life by the Health Assessment Questionnaire (HAQ). The psoriasis severity was determined using the Psoriasis Area Severity Index (PASI) and the activity of arthritis by the disease activity score of 28 joints (DAS 28). The Visual Analogue Scale (VAS) was used to assess the severity of pain.

Poor sleep quality was found in 67.7% of PsA patients, 57.7% in Ps patients and 14.6% within the control group. Sleeping disorders in patients with PsA and Ps were related to worse quality of life and intense fatigue. Methotrexate treatment was not related to sleeping disorders, but an improvement in sleep quality was observed in both PsA and Ps patients who were treated with anti TNF- antibodies (p < 0.001 and p = 0.032 respectively). Following the use of the linear regression model, the following factors worsen the sleep quality in PsA: pain (R2 = 0.462, p < 0.001), tender joint count (R2 = 0.434, p < 0.001), C-reactive protein (CRP) concentration (R2 = 0.391, p < 0.001), patient’s age (R2 = 0.284, p = 0.003) and duration of psoriasis (R2 = 0.166, p = 0.006). In Ps patients the factors were: severity of skin lesions (R2 = 0.329, p < 0.001), duration of psoriasis (R2 = 0.290, p = 0.004) and patient’s age (R2 = 0.282, p = 0.019).

Poor sleep quality in patients with PsA or Ps is a common symptom. Sleep disorders are more frequent in patients with PsA than in those with psoriasis.

Mease PJ, Menter MA. Quality-of-life issues in psoriasis and psoriatic arthritis: outcome measures and therapies from a dermatological perspective. J Am Acad Dermatol 2006; 54: 685-704.
Gudu T, Gossec L. Quality of life in psoriatic arthritis. Expert Rev Clin Immunol 2018; 14: 405-417.
Husni ME, Merola JF, Davin S. The psychosocial burden of psoriatic arthritis. Semin Arthritis Rheum 2017; 47: 351-360.
Tezel N, Yilmaz Tasdelen O, Bodur H, et al. Is the health-related quality of life and functional status of patients with psoriatic arthritis worse than that of patients with psoriasis alone? Int J Rheum Dis 2015; 18: 63-69.
Krajewska-Włodarczyk M, Owczarczyk-Saczonek A, Placek W. Fatigue – an underestimated symptom in psoriatic arthritis. Reumatologia 2017; 55: 125-130.
Gowda S, Goldblum OM, McCall WV, et al. Factors affecting sleep quality in patients with psoriasis. J Am Acad Dermatol 2010; 63: 114-123.
Thomas SJ, Calhoun D. Sleep, insomnia, and hypertension: current findings and future directions. J Am Soc Hypertens 2017; 11: 122-129.
van Leeuwen WMA, Lehto M, Karisola P, et al. Sleep restriction increases the risk of developing cardiovascular diseases by augmenting proinflammatory responses through IL-17 and CRP. PLoS One 2009; 4: e4589.
Van Cauter E, Spiegel K, Tasali E, et al. Metabolic consequences of sleep and sleep loss. Sleep Med 2008; 9: 23-28.
Vgontzas AN, Zoumakis E, Bixler EO, et al. Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines. J Clin Endocrinol Metab 2004; 89: 2119-2126.
Irwin MR, Olmstead R, Carroll JE. Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry 2016; 80: 40-52.
Taylor W, Gladman D, Helliwell P, et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54: 2665-2673.
Mrowietz U, Kragballe K, Reich K, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res 2011; 301: 1-10.
Praevoo ML, van’t Hof MA, Kuper HH, et al. Modified disease activity scores that include twenty-eight-joint counts. Arthritis Rheum 1995; 38: 44-48.
Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193-213.
Bruce B, Fries JF. The Stanford health assessment questionnaire (HAQ): a review of its history, issues, progress, and documentation. J Rheumatol 2003; 30: 167-178.
www.facit.org/FACITOrg/Questionnaires (access on 30.01.2017).
Henry AL, Kyle SD, Bhandari S, et al. Measurement, classification and evaluation of sleep disturbance in psoriasis: a systematic review. PLoS One 2016; 11: e0157843.
Gezer O, Batmaz İ, Sariyildiz M A, et al. Sleep quality in patients with psoriatic arthritis. Int J Rheum Dis 2017; 20: 1212-1218.
Nie A, Wang C, Song Y, et al. Prevalence and factors associated with disturbed sleep in outpatients with ankylosing spondylitis. Clin Rheumatol 2018; 37: 2161-2168.
Li Y, Zhang S, Zhu J, et al. Sleep disturbances are associated with increased pain, disease activity, depression, and anxiety in ankylosing spondylitis: a case-control study. Arthritis Res Ther 2012; 14: R215.
Melikoglu M. Sleep Quality and its Association with Disease Severity in Psoriasis. Eurasian J Med 2017; 49: 124-127.
Jensen P, Zachariae C, Skov L, et al. Sleep disturbance in psoriasis - a case-controlled study. Br J Dermatol 2018. doi: 10.1111/bjd.16702 [Epub ahead of print].
Henry AL, Kyle SD, Chisholm A, et al. A cross-sectional survey of the nature and correlates of sleep disturbance in people with psoriasis. Br J Dermatol 2017; 177: 1052-1059.
Shutty BG, West C, Huanq KE, et al. Sleep disturbance in psoriasis. Dermatol Online J 2013; 19: 1.
Stinco G, Trevisan G, Piccirillo F, et al. Psoriasis vulgaris does not adversely influence the quality of sleep. G Ital Dermatol Venereol 2013; 148: 655-669.
Callis Duffin K, Wong B, Horn EJ, et al. Psoriatic arthritis is a strong predictor of sleep interference in patients with psoriasis. J Am Acad Dermatol 2009; 60: 604-608.
Strober BE, Sobell JM, Duffin KC, et al. Sleep quality and other patient-reported outcomes improve after patients with psoriasis with suboptimal response to other systemic therapies are switched to adalimumab: results from PROGRESS, an open label Phase IIIB trial. Br J Dermatol 2012; 167: 1374-1381.
Carneiro C, Chaves M, Verardino G, et al. Fatigue in psoriasis with arthritis. Skinmed 2011; 9: 34-37.
Wu C-Y, Chang Y-T, Juan C-K, et al. Depression and insomnia in patients with psoriasis and psoriatic arthritis taking tumor necrosis factor antagonists. Medicine 2016; 95: e3816.
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