Sleep Disturbances in Psoriatic Arthritis: A Bidirectional Link Between Inflammation, Pain, and Disease Activity
DOI:
https://doi.org/10.12775/QS.2026.73.75029Keywords
psoriatic arthritis, sleep disordersAbstract
Background. Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with significant disability and systemic comorbidities. Sleep disturbances are common but often underrecognized contributors to disease burden.
Aim. To summarize current evidence on the epidemiology, mechanisms, clinical impact, assessment, and management of sleep disturbances in PsA.
Material and Methods. A narrative review of the literature was performed using PubMed and Scopus. PubMed was searched (2020–2026) using the terms “psoriatic arthritis” AND “sleep disorders”, while Scopus was searched (2021–2026) using “sleep” AND “psoriatic arthritis”.
Results. Sleep disturbances affect a large proportion of patients with PsA, with poor sleep quality reported in up to 84% of patients and overall sleep disorders affecting approximately 30–70%. Insomnia, obstructive sleep apnea, restless legs syndrome, excessive daytime sleepiness, and circadian rhythm disturbances were the most frequently reported conditions. Sleep impairment was consistently associated with increased pain, fatigue, anxiety, depression, reduced quality of life, impaired physical functioning, and higher disease activity. Current evidence supports a bidirectional relationship between sleep disturbances and systemic inflammation, mediated by pro-inflammatory cytokines, neuroendocrine dysregulation, and altered sleep architecture.
Conclusions. Sleep disturbances represent a highly prevalent but underrecognized comorbidity in PsA and contribute substantially to disease burden and reduced quality of life. Their multifactorial pathogenesis highlights the need for a multidisciplinary approach that integrates routine sleep assessment into standard PsA management. Future studies employing standardized and objective sleep measures are needed to optimize screening strategies and develop targeted interventions aimed at improving both sleep and overall disease outcomes.
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