Sleep Disorders Common in Patients With Chronic Urticaria

Sleep disorder–related symptoms are more common in patients with chronic spontaneous urticaria compared with control individuals, according to study data published in the Journal of Cosmetic Dermatology.

The retrospective study included 21 patients with chronic spontaneous urticaria (mean age, 41.8±13 years; 81% women) who were not receiving regular treatment within the previous 30 days. A control group included 19 healthy volunteers (mean age, 46±11.6 years; 36.8% women) who did not have any comorbidities and had normal polysomnography findings.

The study authors obtained demographic characteristics, urticaria activity scores (UAS7), Chronic Urticaria Quality-of-Life Questionnaire (CU–Q2oL) scores, Epworth Sleepiness Scale (ESS) scores, Pittsburgh Sleep Quality Index (PSQI) scores, and polysomnography (PSG) findings from the patients’ files.

The patients with chronic spontaneous urticaria had a median disease duration of 12 months (range, 3-240 months) and were significantly more likely to have all 4 symptoms of sleep apnea (snoring, witnessed apnea, sleepiness, and fatigue) compared with the control group (47.6% vs 0%, P =.001).

Among the patients with chronic spontaneous urticaria, the median ESS score (10 vs 4, P <.001) and the percentages of those with an ESS score of 10 or higher (52.4% vs 5.3%, P =.004) and an apnea hypopnea index (AHI) score of 5 or higher (44.4% vs 5.3%, P = .017) were higher compared with the rates observed in the control group. The median AHI scores were comparable in the 2 groups (P >.05).

For patients with chronic spontaneous urticaria, the CU–Q2oL total score was positively correlated with sleep latency (r=0.713, P =.004) and PSQI–C1 score (r=0.726, P =.005). It was negatively correlated with urticaria duration (r=-0.579, P =.015), AHI (r=-0.607, P =.021), longest apnea duration (r=-0.583, P =.029), total number of respiratory events (r=-0.618, P =.018), apnea count (r=-0.686, P =.007), REM AHI score (r=-0.639, P =.014), and non-REM AHI score (r=-0.634, P =.015).

CU–Q2oL sleep problems subscale (SPS) scores were positively correlated with sleep latency (r=0.620, P =.018), PSQI–C1 scores (subjective sleep quality) (r=0.486, P =.042), and PSQI–C5 scores (sleep disturbances) (r=0.453, P =.040). CU–Q2oL SPS scores were negatively correlated with longest apnea duration (r=0.569, P =.034), apnea count (r=-0.537, P =.038), and REM/non-REM AHI ratio (r=-0.626, P =.022).

Study limitations include the small population and retrospective design, as the researchers were unable to assess other factors that may affect sleep, including infection, psychiatric illness, or use of stimulants, as well as the cause-and-effect relationship between disease scores and sleep parameters.

“We found that poor quality of life was associated with trouble falling asleep, trouble maintaining sleep, and subjective sleep quality in chronic spontaneous urticaria patients,” the study authors commented.

Reference

Ates H, Firat S, Buhari GK, Keren M, Cifci B, Erkekol BO. Relationships between quality of life, sleep problems, and sleep quality in patients with chronic idiopathic urticaria. J Cosmet Dermatol. Published online February 14, 2022. doi:10.1111/jocd.14851