Prevalence of insomnia and its association with itch in chronic pruritic dermatoses: A cross-sectional study from a tertiatry care hospital

Abstract

BACKGROUND: Sleep and itch are two important factors to be considered in understanding the psychosocial adaptation of chronic skin disorders. There are research gaps in understanding the interplay of these symptoms in patients with chronic pruritus. OBJECTIVE: The primary objective of the study was to estimate the proportion of insomnia in patients with chronic pruritus. The secondary objective was to determine the association of insomnia with the various dimensions of itch. METHODS: This was a 6-month cross-sectional study done from September 1, 2022, to March 1, 2023, conducted in the outpatient services of the department of dermatology at a tertiary care hospital. Operational definitions for chronic pruritus and insomnia were defined. A sample of 162 patients with chronic pruritus was included in the study through convenience sampling. The included participants were asked to fill in the 5D itch scale and Insomnia Severity Index scale to assess itch and insomnia, respectively. Descriptive analysis was carried out for quantitative and categorical variables. The itch scores were compared between insomnia and noninsomnia groups with Chi-square and Fisher's exact test, Mann–Whitney U-test, and receiver operating characteristic analyses. RESULTS: Insomnia was reported in 66 (40.7%) of the patients with chronic pruritus. Irrespective of the dermatological diagnoses, total itch severity, degree, duration, and disability of itch were the factors associated with insomnia. CONCLUSION: There is an underestimated burden of insomnia in patients with chronic pruritus. The severity of insomnia was associated significantly with the total itch score, degree, duration, and disability dimensions of itch.

Keywords

• chronic
• disability
• insomnia
• itch
• pruritus
• sleep