The Impact of Sleep Dysfunction on Inflammatory Skin Diseases: A Systematic Review

No SJR dataJan 20, 2026Cureus

How Sleep Problems Are Linked to Inflammatory Skin Diseases

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

A systematic review of 13 studies involving approximately 189,000 participants identified significant sleep disturbances in chronic inflammatory skin diseases.

In atopic dermatitis, poor sleep is strongly associated with increased severity of skin symptoms and higher itch intensity.
In psoriasis, poor sleep correlates with greater severity of skin involvement and higher impairment in quality of life.
Depression may mediate the relationship between quality of life impairment and sleep disturbances in psoriasis patients.
Genetic evidence suggests a potential causal link between insomnia and an increased risk of developing atopic dermatitis and psoriasis.
The interplay between nocturnal itching, emotional distress, and inflammation may exacerbate sleep disturbances in these skin conditions.

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Sleep disturbance is increasingly recognized as a major comorbidity in chronic inflammatory skin diseases, driven by altered sleep architecture, circadian disruption, and pruritus-related nocturnal symptoms that exacerbate disease activity and reduce quality of life. This systematic review of 13 studies (N ≈ 189,000) identified the prevalence, correlates, and clinical implications of sleep disturbance across major dermatologic conditions, focusing on atopic dermatitis (AD) and psoriasis. In AD, poor sleep showed strong associations with higher Scoring Atopic Dermatitis (SCORAD) and Patient-Oriented Eczema Measure (POEM) scores and greater pruritus intensity, with itch emerging as the primary predictor of sleep disruption. In psoriasis, poor sleep was closely linked to higher Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores and more severe pruritus, with depression mediating the impact of quality-of-life impairment on sleep. Genetic evidence further supported a causal relationship between insomnia and increased risk of AD and psoriasis. Collectively, findings reveal a bidirectional interplay in which nocturnal pruritus, emotional distress, and inflammation sustain one another, underscoring sleep disturbance as an integral component of dermatologic disease burden and highlighting the need for routine sleep assessment, targeted interventions, and longitudinal studies to determine whether improving sleep can reduce inflammatory activity and enhance patient outcomes.

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