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结节性痒疹患者发生睡眠障碍的风险:一项使用健康改善网络的人群水平分析。

Risk of incident sleep disorders in patients with prurigo nodularis: A population-level analysis using The Health Improvement Network.

作者信息

Joel Marina Z, Taylor Matthew T, Cornman Hannah L, Kambala Anusha, Reddy Sriya V, Gabriel Sylvie, Kwatra Shawn G

机构信息

Department of Dermatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Galderma SA, Lausanne, Switzerland.

出版信息

JAAD Int. 2023 Jul 29;13:39-45. doi: 10.1016/j.jdin.2023.07.009. eCollection 2023 Dec.

Abstract

BACKGROUND

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.

OBJECTIVE

To evaluate the association of PN with sleep disorders.

METHODS

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.

RESULTS

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).

LIMITATIONS

As a retrospective cohort study, our analysis is subject to potential confounders not already included.

CONCLUSIONS

PN was associated with subsequent development of insomnia. Thus, clinicians should consider insomnia among patients with PN and develop strategies for treatment and prevention.

摘要

背景

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。

目的

评估PN与睡眠障碍之间的关联。

方法

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。

结果

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。

局限性

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。

结论

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。

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本文引用的文献

1
Prurigo Nodularis.结节性痒疹
JAMA Dermatol. 2022 Mar 1;158(3):336. doi: 10.1001/jamadermatol.2021.5307.
2
Health-related quality of life and economic burden of prurigo nodularis.结节性痒疹的健康相关生活质量和经济负担
J Am Acad Dermatol. 2022 Mar;86(3):573-580. doi: 10.1016/j.jaad.2021.05.036. Epub 2021 May 28.
4
Prurigo nodularis: Epidemiology and clinical features.结节性痒疹:流行病学和临床特征。
J Am Acad Dermatol. 2020 Dec;83(6):1559-1565. doi: 10.1016/j.jaad.2020.04.183. Epub 2020 May 23.
6
Breaking the Itch-Scratch Cycle in Prurigo Nodularis.打破结节性痒疹的瘙痒-搔抓循环
N Engl J Med. 2020 Feb 20;382(8):757-758. doi: 10.1056/NEJMe1916733.
10
Real-World Prevalence of Prurigo Nodularis and Burden of Associated Diseases.结节性痒疹的真实世界患病率及相关疾病负担
J Invest Dermatol. 2020 Feb;140(2):480-483.e4. doi: 10.1016/j.jid.2019.07.697. Epub 2019 Aug 15.

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