Understanding the experience of sleep disturbance in psoriasis: A qualitative exploration using the Common Sense, Self‐Regulation Model

ABSTRACT

Background

Psoriasis is associated with significant morbidity which negatively impacts upon quality of life. Sleep disturbance is reported by patients to be common in psoriasis and is associated with physical and psychological variables, although there is little published work in this area. Understanding sleep and the factors involved in its disturbance in psoriasis is a potentially important clinical area given the role of sleep in health and disease processes.

Objective

To explore the experience of sleep and sleep disturbance in psoriasis using the Common‐Sense‐Self‐Regulation Model (CS‐SRM).

Method

Semi‐structured interviews were conducted with adults diagnosed with psoriasis. Interview questions were informed by the CS‐SRM and previous research. Framework analysis was applied, including coding data into the CS‐SRM dimensions and allowing additional inductive themes to emerge.

Results

Seventeen people with psoriasis (9 female, 8 male; aged 19‐86) were interviewed about sleep and sleep disturbance. Seven themes emerged, with six accounted for by the CS‐SRM: characteristics of sleep disturbance, change in sleep patterns, thoughts about and symptoms of disease disturbing sleep, impact of poor sleep on daily life, attempts to improve sleep, a daily battle for control and a seventh relating to metacognitive processes. A reciprocal relationship between sleep and psoriasis was evident across themes with interactions between key sleep‐related thoughts, emotions and behaviours.

Conclusion

This study showed that sleep disturbance is a persistent concern for people with psoriasis, it has a 24‐hour impact, and interacts with psychological and physical aspects of psoriasis. The distress and frustration felt when managing sleep disturbance perpetuated problematic sleep. Addressing this with currently available sleep treatments may therefore confer sleep and psoriasis‐related benefits for people living with this condition.

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