Sleep disturbance in adults with chronic pruritic dermatoses is associated with increased C-reactive protein levels

医学 优势比 置信区间 睡眠障碍 内科学 全国健康与营养检查调查 回忆偏差 逻辑回归 C反应蛋白 全身炎症 生活质量(医疗保健) 横断面研究 生物标志物 睡眠(系统调用) 早晨 炎症 失眠症 病理 精神科 人口 化学 护理部 操作系统 环境卫生 生物化学 计算机科学
作者
Sagar P. Patel,Raveena Khanna,Justin Choi,Kyle A. Williams,Youkyung S. Roh,Michael Hong,Nishadh Sutaria,Thomas Pritchard,Madan M. Kwatra,Shawn G. Kwatra
出处
期刊:Journal of The American Academy of Dermatology [Elsevier BV]
卷期号:84 (2): 265-272 被引量:13
标识
DOI:10.1016/j.jaad.2020.08.059
摘要

Background Pruritus is a common symptom that can significantly reduce quality of life through sleep disruption. Objective To examine features of disturbed sleep in patients with chronic pruritic dermatoses and test the hypothesis that systemic inflammation may serve as a biomarker for impaired sleep in these patients. Methods Cross-sectional analysis of the National Health and Nutrition Examination Survey investigating systemic inflammation using C-reactive protein (CRP) levels. Logistic regression was used to compare patients with and without sleep disturbances, adjusting for demographics (model 1) and medical comorbidities (model 2). Results Chronic pruritic dermatoses were associated with multiple sleep disturbances, including nighttime awakenings (model 1: odds ratio [OR], 1.646; 95% confidence interval [CI], 1.031-2.627; model 2: OR, 1.329; 95% CI, 0.888-1.989) and early morning awakening (model 1: OR, 1.669, 95% CI, 1.118-2.493; model 2: OR, 1.582; 95% CI, 1.008-2.481). Mean CRP levels were 52.8% higher among patients with pruritic dermatoses reporting trouble sleeping compared with those who did not (0.663 vs 0.434 mg/dL; P = .034). Trouble sleeping was also positively correlated with CRP levels (β = 0.142, P = .025). Limitations Potential recall bias among participants. Conclusions In addition to confirming sleep disturbances with pruritic dermatoses, we found these disturbances are more likely to present with elevated CRP levels. Clinicians should consider the potential risk for sleep-related and cardiac comorbidities in patients diagnosed with itchy skin conditions. Pruritus is a common symptom that can significantly reduce quality of life through sleep disruption. To examine features of disturbed sleep in patients with chronic pruritic dermatoses and test the hypothesis that systemic inflammation may serve as a biomarker for impaired sleep in these patients. Cross-sectional analysis of the National Health and Nutrition Examination Survey investigating systemic inflammation using C-reactive protein (CRP) levels. Logistic regression was used to compare patients with and without sleep disturbances, adjusting for demographics (model 1) and medical comorbidities (model 2). Chronic pruritic dermatoses were associated with multiple sleep disturbances, including nighttime awakenings (model 1: odds ratio [OR], 1.646; 95% confidence interval [CI], 1.031-2.627; model 2: OR, 1.329; 95% CI, 0.888-1.989) and early morning awakening (model 1: OR, 1.669, 95% CI, 1.118-2.493; model 2: OR, 1.582; 95% CI, 1.008-2.481). Mean CRP levels were 52.8% higher among patients with pruritic dermatoses reporting trouble sleeping compared with those who did not (0.663 vs 0.434 mg/dL; P = .034). Trouble sleeping was also positively correlated with CRP levels (β = 0.142, P = .025). Potential recall bias among participants. In addition to confirming sleep disturbances with pruritic dermatoses, we found these disturbances are more likely to present with elevated CRP levels. Clinicians should consider the potential risk for sleep-related and cardiac comorbidities in patients diagnosed with itchy skin conditions.
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