[Restricted sleep as a secondary psychosocial consequence of facial palsy].

BACKGROUND

Facial palsy (FP) is a paralysis of facial muscles and one of the most common motor failures. It is associated with intense impairment of health related quality of life and depressive symptoms. Sleep disorders as a result of FP are often attributed to illness-related impairments, although psychosocial problems might also be the cause. This study examined the direct and indirect effects of FP on sleep quality.

METHODS

The sample of this cross-sectional study included N = 81 patients with FP. Symptoms of FP (FACE), sleep quality (PSQI), quality of life (SF36), depression (PHQ9) and social anxiety (LSAS) were measured. Mediation models were used to investigate the relationship between symptoms of FP, social anxiety, depression and sleep quality.

RESULTS

Sleep quality was decreased in 33.3 % of patients. The subjective severity of the FP correlated significantly with sleep quality. Mediation analyses suggest a causal link between the severity of FP, symptoms of social anxiety, depressive symptoms and restricted sleep quality. However, including social anxiety and depression as mediators resulted in no direct effects of FP on sleep quality.

CONCLUSION

Sleep problems related to FP seem to be caused less by physical than by an indirect consequence of psychosocial impairment. The change in the face associated with FP causes psychological problems which in turn lead to reduced sleep quality. The medical care of FP patients should therefore also consider the psychosocial consequences in order to prevent the onset of mental disorders (such as depression) and sleep disorders.