Sleep Disturbance in Patients with Urticaria and Atopic Dermatitis: An Underestimated Burden

This study examined the relationship between insomnia and the frequent itching skin diseases, atopic dermatitis and chronic urticaria. Patients with chronic inflammatory dermatological diseases with pruritus were evaluated for insomnia (Insomnia Severity Index; ISI) and impairment in dermatological quality of life (Dermatology Life Quality Index; DLQI). Disease activity was measured using validated scores. A total of 61 patients participated in the study. Patients with atopic dermatitis had a mean ISI score of 8.7 before flares and 16 when a flare occurred. The mean DLQI score in atopic dermatitis was 11.4. The mean ISI score in patients with chronic urticaria was 6.8 before flares and 14.9 when a flare occurred. In patients with chronic urticaria the mean DLQI score was 8.5. An increase in insomnia during a disease flare was demonstrated in both groups. Thus, sleep is a factor to consider during treatment of itching skin diseases. The results of this pilot study indicate that pruritus may not be the only reason for insomnia in patients with atopic dermatitis or chronic urticaria.