Update on Sleep and Pulmonary Comorbidities in Psoriasis

The purpose of this review article is to provide an overview of sleep and pulmonary comorbidities in patients with psoriasis and summarize important recent findings.

Evidence continues to show that patients with psoriasis experience greater chronic sleep impairment when compared to healthy counterparts. In addition to other comorbidities seen in psoriasis patients, including cardiovascular disease, obesity, and diabetes, obstructive sleep apnea and chronic obstructive pulmonary disease have increased frequency in this population.

Sleep and pulmonary comorbidities in psoriasis contribute to disease burden and impaired quality of life in psoriasis patients. The evaluation of sleep comorbidities is complicated by the overlap with other comorbidities such as depression and anxiety. Regardless, there is strong evidence to indicate an elevated prevalence of insomnia in psoriasis patients. A causal relationship between psoriasis and insomnia has yet to be determined. There is moderate evidence to suggest increased risk of developing OSA in psoriasis patients, even when accounting for increased BMI. Most studies on sleep impairment in psoriasis patients have used self-reported data, of which only a portion has been validated. As such, there is a need to better evaluate sleep dysfunction in psoriasis patients. Regarding pulmonary comorbidities, psoriasis patients are more likely to smoke compared to the general population, which complicates evaluation of risk of COPD, lung cancer, and pulmonary infections in this population.