The Link Between Psoriasis and Insomnia

by Martin Reed Patient Advocate

Psoriasis is a chronic disease characterized by skin inflammation and an increased production of skin cells due to an overactive immune system. Although the body produces new skin cells much faster than normal, it does not shed them as quickly, resulting in older skin cells piling up onto each other.

The result is red, itchy, flaky patches of skin (known as plaques).

Those with moderate to severe psoriasis often suffer from depression and insomnia. One study found that more than 10 percent of psoriasis patients suffer from clinical depression and twice as many have depression symptoms. Another study concluded that as many as 45 percent of psoriasis patients suffer from insomnia symptoms.

Why Is There a Link Between Psoriasis and Insomnia?

The itching sensation and pain associated with psoriasis can make sleep difficult. Furthermore, the health conditions associated with psoriasis (such as depression, hypertension, and diabetes) are also known to be associated with sleep issues.

The Effect of Biologic Therapy on Depression and Insomnia

A nationwide cohort study published in 2016 aimed to determine the effectiveness of a specific psoriasis treatment when it came to alleviating the symptoms of depression and insomnia.

The study involved 980 individuals (677 men and 303 women) with psoriatic arthritis or psoriasis who had received biologics therapy between 2009 and 2012.

Prevalence rates of depression/insomnia or antidepressant use were compared one year before beginning biologic therapy and after two years of biologics therapy.

Researchers found that up to 20 percent of individuals suffered from depression/insomnia before undergoing biologic therapy. Prevalence rates decreased within three months of biologics treatment and continued to decline during the follow up period. After two years, there was a 43.8 percent decrease in depression/insomnia prevalence.

The study also found that uninterrupted biologic therapy was more effective at treating symptoms of depression and insomnia compared to interrupted biologics therapy.

In comparison, those who only took disease-modifying antirheumatic drugs (DMARDs) saw a decrease in depression/insomnia rates of only between 10 and 11 percent.

Why Does Biologics Therapy Ease Depression and Insomnia Symptoms?

Biologics therapy might ease depression and insomnia symptoms because of the TNF-alpha inhibition found in certain biologic. TNF-alpha is a cytokine involved in the body's inflammatory response. Inflammation is linked to a number of conditions such as insomnia, pain, and depression.

TNF-alpha has been shown to play a key role in the development of depression. One study found that acutely depressed individuals have higher levels of TNF-alpha in their blood. The TNF-alpha inhibitors in biologics therapy help reduce the body's inflammatory response, which may alleviate the symptoms of conditions associated with inflammation.

Psoriasis Does Not Have a Cure

Although biologic therapy holds a lot of promise for psoriasis sufferers, it's worth emphasizing that there is not yet a cure for psoriasis.

Speak with your doctor to see if biologic therapy for psoriasis is right for you. As the latest research suggests, this form of treatment may be particularly helpful if you also suffer from depression and insomnia.

You can also help alleviate insomnia symptoms by practicing good sleep hygiene. This includes sticking to a regular sleep schedule, exercising, and limiting alcohol and caffeine consumption.

Martin Reed
Meet Our Writer
Martin Reed

Martin is the creator of Insomnia Coach, an eight-week course that combines online sleep education with individual sleep coaching. His course helps clients improve their sleep so they can enjoy a better life with more energy and start each day feeling happy, healthy, rested, and refreshed. Martin also runs a free sleep training course that has helped over 5,000 insomniacs. He holds a master’s degree in health and wellness education and studied clinical sleep health at the University of Delaware.