Joel Marina Z, Taylor Matthew T, Cornman Hannah L, Kambala Anusha, Reddy Sriya V, Gabriel Sylvie, Kwatra Shawn G
Department of Dermatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Galderma SA, Lausanne, Switzerland.
JAAD Int. 2023 Jul 29;13:39-45. doi: 10.1016/j.jdin.2023.07.009. eCollection 2023 Dec.
Prurigo nodularis (PN) is a chronic inflammatory skin condition characterized by severely itchy and often painful bumps on the arms, legs, and trunk. It is unknown whether patients with PN have increased risk of developing sleep disorders.
To evaluate the association of PN with sleep disorders.
This retrospective, population-level, matched-cohort study was conducted using The Health Improvement Network. The study included 4193 patients with newly diagnosed PN and 4193 age, sex, and race/ethnicity-matched controls. A Cox regression model was used to assess the development of sleep disorders, including insomnia, sleep apnea, and restless legs syndrome, in patients with PN compared with control patients.
Compared with controls, PN was associated with insomnia (adjusted hazard ratio [aHR] = 1.77; 95% CI = 1.48-2.12) and overall sleep disorder (aHR = 1.72; 95% CI = 1.46-2.02), but not with sleep apnea (aHR = 1.51; 95% CI = 0.93-2.44) or restless legs syndrome (aHR = 1.54; 95% CI = 0.92-2.57).
As a retrospective cohort study, our analysis is subject to potential confounders not already included.
PN was associated with subsequent development of insomnia. Thus, clinicians should consider insomnia among patients with PN and develop strategies for treatment and prevention.
结节性痒疹（PN）是一种慢性炎症性皮肤病，其特征是手臂、腿部和躯干上出现严重瘙痒且常伴有疼痛的肿块。目前尚不清楚PN患者患睡眠障碍的风险是否增加。
评估PN与睡眠障碍之间的关联。
本回顾性、基于人群的匹配队列研究使用了健康改善网络。该研究纳入了4193例新诊断为PN的患者以及4193例年龄、性别和种族/民族匹配的对照。采用Cox回归模型评估PN患者与对照患者相比发生睡眠障碍（包括失眠、睡眠呼吸暂停和不宁腿综合征）的情况。
与对照组相比，PN与失眠（调整后风险比[aHR]=1.77；95%置信区间[CI]=1.48-2.12）和总体睡眠障碍（aHR=1.72；95%CI=1.46-2.02）相关，但与睡眠呼吸暂停（aHR=1.51；95%CI=0.93-2.44）或不宁腿综合征（aHR=1.54；95%CI=0.92-2.57）无关。
作为一项回顾性队列研究，我们的分析可能受到未纳入的潜在混杂因素的影响。
PN与随后发生的失眠相关。因此，临床医生应考虑PN患者中的失眠情况，并制定治疗和预防策略。
