Evaluation of Sleep Disturbance in Alopecia Areata through Questionnaire: Pittsburgh Sleep Quality Index as a Reasonable Tool
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Alopecia areata (AA) is common non-scarring hair loss disease. Sleep dis- trubance has been regarded as a triggering or aggravating factor for AA. However, objective evaluation of sleep disturbance and its clinical effect on AA has not been clearly demon- strated. Objective: This study investigated objective sleep evaluation tool for AA patients and their clinical correlation. Methods: Patients presenting with new-onset AA or recurrences of pre-existing AA were in- cluded, and those who reported sleep disturbance in the preliminary survey were designated as the sleep disturbance group (SD group). Sleep quality was investigated for them using three self-administered questionnaires: Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleep Scale (ESS). Demographic information and clinical features of AA were analyzed according to sleep quality. Results: A total of 400 participants were enrolled, and 53 were categorized into the SD group. The incidence of stressful events was significantly higher in the SD group (54.7%) than in the non-SD group (25.1%) (p<0.001). Based on the PSQI, 77.3% of participants were objective poor sleepers (score of 5 or more), and they showed a significantly higher incidence of stressful events compared to good sleepers (p =0.019). The proportion of poor sleepers was significantly lower in patients with mild AA (S1) than in those with moderate to severe AA (S2~S5) (p = 0.045). Conclusion: This study demonstrated a positive correlation among stress, SD, and AA. The degree of SD was objectively represented by the PSQI score, showing different scores accord- ing to AA severity.
Abstract
Background: Alopecia areata (AA) is common non-scarring hair loss disease. Sleep dis- trubance has been regarded as a triggering or aggravating factor for AA. However, objective evaluation of sleep disturbance and its clinical effect on AA has not been clearly demon- strated. Objective: This study investigated objective sleep evaluation tool for AA patients and their clinical correlation. Methods: Patients presenting with new-onset AA or recurrences of pre-existing AA were in- cluded, and those who reported sleep disturbance in the preliminary survey were designated as the sleep disturbance group (SD group). Sleep quality was investigated for them using three self-administered questionnaires: Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleep Scale (ESS). Demographic information and clinical features of AA were analyzed according to sleep quality. Results: A total of 400 participants were enrolled, and 53 were categorized into the SD group. The incidence of stressful events was significantly higher in the SD group (54.7%) than in the non-SD group (25.1%) (p<0.001). Based on the PSQI, 77.3% of participants were objective poor sleepers (score of 5 or more), and they showed a significantly higher incidence of stressful events compared to good sleepers (p =0.019). The proportion of poor sleepers was significantly lower in patients with mild AA (S1) than in those with moderate to severe AA (S2~S5) (p = 0.045). Conclusion: This study demonstrated a positive correlation among stress, SD, and AA. The degree of SD was objectively represented by the PSQI score, showing different scores accord- ing to AA severity.
참고문헌 (19)
- 이누리, "Differences in Comorbidity Profiles between Early-Onset and Late-Onset Alopecia Areata Patients: A Retrospective Study of 871 Korean Patients", Annals of Dermatology, 26(6), pp.722~726 (2014), 대한피부과학회
- García-Hernández MJ, "Alopecia areata, stress and psychiatric disorders : a review", J Dermatol, 26, pp.625~632 (1999)
- Xerfan EMS, "Alopecia areata and sleep quality : is there an interaction?", J Eur Acad Dermatol Venereol, 33, pp.e405~e406 (2019)
- Güleç AT, "The role of psychological factors in alopecia areata and the impact of the disease on the quality of life", Int J Dermatol, 43, pp.352~356 (2004)
- Seo HM, "The risk of alopecia areata and other related autoimmune diseases in patients with sleep disorders : a Korean population-based retrospective cohort study", Sleep, 41, pp.zsy111~ (2018)
- Sohn SI, "The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index", Sleep Breath, 16, pp.803~812 (2012)
- 조용원, "Validation of a Korean Version of the Insomnia Severity Index", Journal of Clinical Neurology, 10(3), pp.210~215 (2014), 대한신경과학회[DOI]
- Cho YW, "The reliability and validity of the Korean version of the Epworth sleepiness scale", Sleep Breath, 15, pp.377~384 (2011)
- Hordinsky M, "Autoimmunity : alopecia areata", J Investig Dermatol Symp Proc, 9, pp.73~78 (2004)
- Barahmani N, "History of atopy or autoimmunity increases risk of alopecia areata", J Am Acad Dermatol, 61, pp.581~591 (2009)
- Tan E, "The pattern and profile of alopecia areata in Singapore--a study of 219 Asians", Int J Dermatol, 41, pp.748~753 (2002)
- Kakourou T, "A case series of alopecia areata in children : impact of personal and family history of stress and autoimmunity", J Eur Acad Dermatol Venereol, 21, pp.356~359 (2007)
- Chu SY, "Comorbidity profiles among patients with alopecia areata : the importance of onset age, a nationwide population-based study", J Am Acad Dermatol, 65, pp.949~956 (2011)
- Simakou T, "Alopecia areata : a multifactorial autoimmune condition", J Autoimmun, 98, pp.74~85 (2019)
- Dai YX, "Bidirectional association between alopecia areata and sleep disorders : a population-based cohort study in Taiwan", Sleep Med, 75, pp.112~116 (2020)
- Nunes JOF, "Sleep deprivation predisposes allergic mice to neutrophilic lung inflammation", J Allergy Clin Immunol, 141, pp.1018~1027 (2018)
- Besedovsky L, "The sleep-immune crosstalk in health and disease", Physiol Rev, 99, pp.1325~1380 (2019)
- Inui S, "Sleep quality in patients with alopecia areata : questionnaire-based study", Int J Dermatol, 53, pp.e39~e41 (2014)
- Lee SY, "Factors associated with poor sleep quality in the Korean general population : providing information from the Korean version of the Pittsburgh Sleep Quality Index", J Affect Disord, 271, pp.49~58 (2020)