Duan Grace Y, Silverberg Jonathan I
Pritzker School of Medicine, The University of Chicago, Chicago, Illinois.
Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
J Am Acad Dermatol. 2023 Feb;88(2):421-427. doi: 10.1016/j.jaad.2022.06.008. Epub 2022 Jun 11.
Chronic inflammatory skin diseases (CISD), such as atopic dermatitis and psoriasis, are associated with nocturnal sleep disturbances, which may in turn exacerbate inflammation.
To summarize the complex factors that underlie the relationship between CISD and sleep impairment.
We conducted a focused review of the published literature, including retrospective, prospective, and interventional studies, clinical trials, reviews, and consensus guidelines.
The results of our literature review identified a complex interplay among various physiological, psychosocial, and behavioral factors mediating the relationship between sleep loss and CISD alongside targeted management strategies. We highlight treatment strategies that target these pathways, providing a practical framework for clinicians managing sleep loss in patients with CISD. Current guidelines by dermatology societies on the management of sleep disturbances in patients with CISD are limited and largely focus mostly on atopic dermatitis and psoriasis.
We recommend that sleep problems must be regularly assessed and managed in patients with CISD. Updated clinician guidelines are needed to better recognize and address the multifactorial nature of sleep loss in patients with CISD.
慢性炎症性皮肤病（CISD），如特应性皮炎和银屑病，与夜间睡眠障碍有关，而睡眠障碍反过来可能会加剧炎症。
总结CISD与睡眠障碍之间关系的复杂因素。
我们对已发表的文献进行了重点综述，包括回顾性、前瞻性和干预性研究、临床试验、综述以及共识指南。
我们的文献综述结果表明，在介导睡眠不足与CISD之间关系的各种生理、心理社会和行为因素以及有针对性的管理策略之间存在复杂的相互作用。我们重点介绍了针对这些途径的治疗策略，为管理CISD患者睡眠不足的临床医生提供了一个实用框架。皮肤病学会目前关于CISD患者睡眠障碍管理的指南有限，且主要大多集中在特应性皮炎和银屑病上。
我们建议必须对CISD患者的睡眠问题进行定期评估和管理。需要更新临床医生指南，以更好地认识和解决CISD患者睡眠不足的多因素性质。
