Relationship between rosacea and sleep

Abstract

Rosacea is a chronic facial skin disease involved in neurovascular dysregulation and neurogenic inflammation. Behavioral factors such as stress, anxiety, depression and sleep were identified to be associated with other inflammatory skin diseases. Few studies have reported sleep status in rosacea. Aiming to investigate the relationship between rosacea and sleep, a case-control survey was conducted, enrolling 608 rosacea patients and 608 sex-and age-matched healthy controls. Sleep quality was assessed through the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Diagnosis and severity grading of rosacea were evaluated under the standard guidelines of the National Rosacea Society. More rosacea patients (52.3%, n = 318) suffered poor sleep quality (PSQI, >5) than the healthy controls (24.0%, n = 146), displaying a much higher PSQI score (rosacea vs control, 6.20 vs 3.95). There was a strong association between sleep quality and rosacea (odds ratio [OR], 3.525; 95% confidence interval [CI], 2.759-4.519). Moreover, the severity of rosacea was also associated with sleep quality (OR, 1.847; 95% CI, 1.332-2.570). Single nucleotide polymorphisms in hydroxytryptamine receptor 2A and adrenoceptor-b1 genes, which are associated with sleep behaviour, were detected and revealed to be associated with rosacea. Furthermore, the LL-37-induced rosacea-like phenotype and sleep-deprivation mice models were applied, revealing that sleep deprivation aggravated the rosacea-like phenotype in mice, with higher expression of matrix metallopeptidase 9, Toll-like receptor 2, cathelicidin antimicrobial peptide and vascular endothelial growth factor. In conclusion, rosacea patients presented poorer sleep quality, as well as a higher propability of genetic background with sleep disturbance. In addition, poor sleep might aggravate rosacea through regulating inflammatory factors, contributing to a vicious cycle in the progression of disease. Logistic regression adjusted by sex, age and BMI. Bold indicates significance. Values of Scores of seven components of the PSQI and global PSQI score are shown as means AE standard deviation. Values of sleep quality (good, bad) are shown as n (%). CI, confidence interval; OR, odds ratio; PSQI, Pittsburgh Sleep Quality Index.

Health Related Quality of Life of Rosacea Patients in China Assessed by Dermatology Life Quality Index and Willingness to Pay

“… 5 Besides, the accompanying subjective symptoms of rosacea (such as burning, stinging and pruritus) may also reduce patients’ quality of life (QoL) or even sleep quality. 6 Another disturbance is the long course of recurrent exacerbations and remissions, 1 which may make patients lose confidence in treatment. Plenty of triggers could cause rosacea to relapse, so patients have to be very careful to modify their productivity and behavior to avoid the recurrence.…”

Bioinformatics and Network Pharmacology Identify the Therapeutic Role and Potential Mechanism of Melatonin in AD and Rosacea

“…showed that MLT can improve sleep quality to mitigate AD neuropathology ( 54 ). Our previous study showed that rosacea patients presented poorer sleep quality, which might subsequently aggravate rosacea through regulating inflammatory factors ( 55 ). So, we speculate that MLT may relieve rosacea partly by regulating sleep quality.…”

<p>Willingness-to-Pay and Benefit–Cost Analysis of IPL for Rosacea Treatment: A Cross-Sectional Study in China</p>

“…Dermatology Life Quality Index (DLQI), a widely used tool to evaluate skin disease patients' quality of life, 23 using six domains, could group its 10 questions as follows: Symptoms, feelings (1,2), Daily activities (3,4), Leisure (5,6), Work/school (7), Personal relationships (8,9), Treatment (10). A higher DLQI score implies a greater QoL impairment.…”

“…In fact, it is exactly the conspicuous facial redness often has a deep impact on the patient's self-esteem and quality of life. 1,7,8 Based on the Clinician's Erythema Assessment (CEA), an authorized measurement for the facial erythema of rosacea, there are 5 levels contained: Clear (Clear skin with no signs of erythema), Almost clear (Almost clear; slight redness), Mild (Mild erythema, definite redness), Moderate (Moderate erythema; marked redness), and Severe (Severe erythema; fiery redness). 9 It is reported that for patients with an "almost clear" evaluation of the erythema, quit a few of them still desired further mitigation of the redness and to achieve "clear".…”