Integrative Approaches to Sleep Management in Skin Disease: Systematic Review

Vishnutheertha A Kulkarni; Isaiah Mojica; Vahram Gamsarian; Michelle Tahjian; David Liu; Tjinder Grewal; Yuyang Liu; Torunn E Sivesind; Peter Lio

doi:10.2196/48713

Integrative Approaches to Sleep Management in Skin Disease: Systematic Review

JMIR Dermatol. 2023 Dec 13:6:e48713. doi: 10.2196/48713.

Authors

Vishnutheertha A Kulkarni¹, Isaiah Mojica², Vahram Gamsarian³, Michelle Tahjian⁴, David Liu⁵, Tjinder Grewal¹, Yuyang Liu¹, Torunn E Sivesind⁶, Peter Lio⁷

Affiliations

¹ University of Queensland Medical School, Brisbane, Australia.
² University of Cincinnati College of Medicine, Cincinnati, OH, United States.
³ University of Michigan School of Medicine, Ann Arbor, MI, United States.
⁴ Nova Southeastern University Dr Kiran C Patel College of Osteopathic Medicine, Fort Lauderdale, FL, United States.
⁵ University of Toledo College of Medicine, Toledo, OH, United States.
⁶ University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
⁷ Northwestern University Feinberg School of Medicine, Chicago, IL, United States.

PMID: 38090791
PMCID: PMC10753428
DOI: 10.2196/48713

Abstract

Background: Dermatological conditions, especially when severe, can lead to sleep disturbances that affect a patient's quality of life. However, limited research exists on the efficacy of treatments for improving sleep parameters in skin conditions.

Objective: The objective was to perform a systematic review of the literature on dermatological conditions and the treatments available for improving sleep parameters.

Methods: A literature review was performed using the PubMed, Ovid MEDLINE, Embase, Cochrane, and ClinicalTrials.gov databases from 1945 to 2021. After filtering based on our exclusion criteria, studies were graded using the SORT (Strength of Recommendation Taxonomy) algorithm, and only those receiving a grade of "2" or better were included.

Results: In total, 25 treatment studies (n=11,025) assessing sleep parameters related to dermatological conditions were found. Dupilumab appeared to be the best-supported and most effective treatment for improving sleep in atopic dermatitis (AD) but had frequent adverse effects. Topical treatments for AD were mostly ineffective, but procedural treatments showed some promise. Treatments for other conditions appeared efficacious.

Conclusions: The evaluation of sleep parameter changes in dermatological treatments is predominantly restricted to AD. Systemic interventions such as dupilumab and procedural interventions were the most efficacious. Sleep changes in other dermatoses were limited by a paucity of available studies. The inclusion of a sleep assessment component to a broader range of dermatological treatment studies is warranted.

Keywords: atopic dermatitis; chronic idiopathic urticaria; dermatologist; dermatology; epidermis; literature review; parameter; polysomnographic; polysomnography; quality of life; review; skin; sleep; sleep medicine; teledermatology.

©Vishnutheertha A Kulkarni, Isaiah Mojica, Vahram Gamsarian, Michelle Tahjian, David Liu, Tjinder Grewal, Yuyang Liu, Torunn E Sivesind, Peter Lio. Originally published in JMIR Dermatology (http://derma.jmir.org), 13.12.2023.

Publication types

Review