Assessment of sleep disturbance in oral lichen planus and validation of PSQI: A case‐control multicenter study from the SIPMO (Italian Society of Oral Pathology and Medicine)

Abstract

Oral lichen planus (OLP) is an immune-mediated inflammatory disease of the oral mucosa characterized by a chronic condition. 1 It may appear with different clinical patterns ranging from keratotic manifestations (K-OLP, white reticular, papular, and/or plaque-like lesions), generally asymptomatic, to predominantly non-keratotic lesions (nK-OLP, atrophic, erythematous, erosive, ulcerative, and/or bullous lesions), 2 which may be symptomatic and impair quality of sleep (QoS), mood, and subsequently the quality of life of the affected patients.The occurrence of two most common sleep disturbances (SDs), insomnia, and daytime sleepiness, with or without mood disorders such as anxiety and depression, has been previously reported in OLP patients (OLPs). 3 However, only a few single center studies have investigated QoS, 4,5 this research based on limited samples, and no data are available in relation to the OLPs with different clinical patterns. Therefore, we aimed to perform a multicenter study in order to further analyze QoS, in a large cohort of OLPs analyzing differences between K-OLP and nK-OLP patterns. Moreover, to the best of our knowledge, this is the first study, which has assessed QoS in such a wide number of OLPs.The objectives of the present study were as follows:• to analyze the prevalence of insomnia and daytime sleepiness and their association with anxiety and depression in patients with keratotic OLP (K-OLPs) and patients with predominant non-keratotic OLP (nK-OLPs), in comparison with a control group of healthy subjects;• to investigate the correlation between poor sleep, anxiety and depression with the oral symptomatology of K-OLP and nK-OLP;• to validate the use of the Pittsburgh Sleep Quality Index (PSQI) in the screening of insomnia in OLPs. | ME THODS | ParticipantsAn observational multicenter case-control study was carried out between December 2018 and January 2020, in accordance with the ethical principles of the World Medical Association Declaration of

Where do you live? North versus Central-South differences in relation to Italian patients with oral lichen planus: a cross-sectional study from the SIPMO (Italian Society of Oral Pathology and Medicine)

“…In our previous studies [ 4 , 19 ], the sample consisted of a total of 600 OLP patients, 330 from the northern regions and 270 from the central-south areas. Therefore, in order to include the same number of patients for each subgroup (Central-South-OLP vs North OLP patients), the patients from the two groups were matched based on gender and age.…”

“…The statistical analyses were performed based on our previous research [ 4 , 19 ] by using the SPSS software v. 23. Descriptive statistics, including means, standard deviations, medians and the interquartile range (IQR), were used to analyze the socio-demographic and clinical characteristics of the four subgroups.…”

The interleukin‐6 family in tissues is closely related to the clinical outcomes of oral lichen planus

“…Patients with nonerosive OLP (NEOLP) only manifest as white lesions, and most patients do not have symptoms such as pain and discomfort, while patients with erosive OLP (EOLP), in addition to white lesions, manifest with erosion, congestion, and ulcers in and/or around the lesions. Most patients with EOLP experience symptoms such as pain and discomfort that are aggravated when eating or talking and adversely affect the patients' physical and mental health 4 . Chronic prolongation and difficult management are representative clinical characteristics of OLP.…”