Psoriasis and Insomnia: The Link Between the Two, and How to Fight It

Patient Expert

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 insomniaOne 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 biologics 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 biologics therapy and after two years of biologics therapy.

Researchers found that up to 20 percent of individuals suffered from depression/insomnia before undergoing biologics 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 biologics 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 inhibitors in biologics therapy. 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 can alleviate the symptoms of conditions associated with inflammation.

Psoriasis does not have a cure

Although biologics 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 biologics 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 scheduleexercising, and limiting alcohol and caffeine consumption.

See More Helpful Articles:

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Revealed: The Thoughts That Are Harming Your Sleep (and What to Do About Them)

Martin is the creator of Insomnia Land’s free insomnia sleep training_ course. His online course uses cognitive behavioral therapy for insomnia techniques to help participants fall asleep and stay asleep. More than 4,000 insomniacs have completed his course and 97 percent of graduates say they would recommend it to a friend._