Sleep disturbance remains insufficiently characterized in many dermatoses.
To investigate the prevalence, burden and factors associated with sleep disturbance in dermatological patients.
We recruited 800 patients and recorded pruritus characteristics, sociodemographic and clinical parameters. Validated questionnaires were employed to assess sleep disturbance, psychological distress, health-related quality of life (HR-QoL), and work productivity.
Two-thirds of patients met criteria of poor sleep, which was associated with psychological distress, diminished HR-QoL, and work productivity loss. Patients with average and maximum pruritus on the visual analogue scale exceeding 5 and 6.5 points, respectively, were at high risk of suffering pruritus-related sleep disturbance. Overall pruritus intensity and its nocturnal exacerbation contributed independently to sleep disturbance. Psychological distress was of even higher impact on sleep than pruritus, and almost one third of the relationship between pruritus intensity and sleep was mediated by psychological distress.
Sleep disturbance is prevalent in dermatological patients and constitutes a considerable burden.
Dermatological patients with intense pruritus and psychological distress should be examined for sleep disorders. Adequate anti-pruritic therapy and complementary psychotherapy in affected patients may help them to regain restorative sleep.

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