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KMID : 0032220230350030183
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Annals of Dermatology
2023 Volume.35 No. 3 p.183 ~ p.189
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Evaluation of Sleep Disturbance in Alopecia Areata through Questionnaire: Pittsburgh Sleep Quality Index as a Reasonable Tool
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Park So-Hee
Ji Ki-Hwan
Kim Jong-Uk
Ahn Sang-Woo
Hong Seong-Min
Jin Woo-Jung
Seol Jung-Eun
Kim Hyo-Jin
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Abstract
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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.
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KEYWORD
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Alopecia areata, Psychological stress, Sleep wake disorders
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