Population-Based Study Links Psoriasis with Sleep Disorders

People with psoriasis are considerably more likely to experience a sleep disorder compared to people without psoriasis, according to a new report based on more than 150,000 patient records.

The findings were presented in a poster at the 2026 American Academy of Dermatology’s Annual Meeting.¹

The authors explained that psoriasis has already been linked with a number of systemic comorbidities. One study, for instance, noted that arthritis, depression, inflammatory bowel disease, and cardiovascular disease have all been associated with psoriasis.² Sleep problems have also been suggested as a common comorbidity among people with psoriasis, but such a link has not yet been clearly defined.

“Emerging evidence suggests a link with sleep disorders, but prior studies were limited by small sample sizes or inadequate control of confounding [factors],” the authors wrote.

The study aimed to address the gap in knowledge using a large, multicenter electronic health record database. The authors used the TriNetX research network to find 84,226 adults with psoriasis and match them with 84,226 controls without psoriasis. The controls were matched by age, sex, and race/ethnicity. People with prior diagnoses of sleep disorders or major confounding factors, such as obesity and smoking, were excluded, the authors said.

The investigators found significant links between psoriasis and various sleep disorders. Those with psoriasis had increased 3-year risks of hypersomnia (risk ratio [RR], 2.043; 95% CI, 1.614-2.586; P < .0001), insomnia (RR, 1.487; 95% CI, 1.342-1.647; P < .0001), restless leg syndrome (RLS; RR, 1.308; 95% CI, 1.056-1.621; P = .0138), and sleep apnea (RR, 1.166; 95% CI, 1.017-1.337; P = .0275).

There was not, however, an increase in the risk of circadian rhythm disorders and parasomnias, the authors said.

Notably, the study also found that a patient’s psoriasis treatment also had associations with sleep outcomes. Patients receiving tumor necrosis factor (TNF) alpha inhibitors or conventional systemic therapies had heightened risks of sleep apnea, and those taking the latter had an increased risk of insomnia. However, inhibitors of interleukins (IL) 17 and 23 appeared to lead to a lower risk of sleep disorders, suggesting they might have a protective effect. The new study is not the first time therapeutic choice has been linked with sleep outcomes in psoriasis.

For instance, a 2023 study in the Journal of Rheumatology found that patients with psoriatic arthritis who took TNF inhibitors, the IL-23 inhibitor guselkumab (Tremfya), or the Janus kinase (JAK) inhibitor filgotinib (Jyseleca) had improved sleep outcomes.³

The new report explained that the link between psoriasis and sleep disorders “is likely multifactorial, driven by pruritus-related sleep disruption and shared inflammatory pathways (e.g. elevated IL-1β, IL-6, IL-12).” That may be why interleukin inhibitors seem to lower the risk of sleep problems.

The authors cited several limitations to their findings, including the retrospective nature of the study’s design and the potential for diagnostic miscoding within the electronic health records in the database. They added that they did not have complete information to capture participants’ potential use of sedatives or other sleep aids. In addition, they noted that sleep disorders tend to be under-diagnosed in routine practice, which could affect the level of risk.

The authors concluded, though, that there is sufficient evidence to conclude that patients with psoriasis face a significantly higher risk of sleep disorders. They said dermatologists should regularly check in with patients with psoriasis to facilitate timely referrals if sleep disorders are suspected. They said prospective studies incorporating objective measures of psoriasis severity and polysomnography are needed to validate the associations and potential treatments.

References

1. Chalupczak NV, Lipner SR. Association of psoriasis with sleep disorders: A population-based retrospective cohort study. Poster presented at: American Academy of Dermatology 2026 Annual Meeting; March 27-31, 2026; Denver, CO.
2. Oliveira Mde F, Rocha Bde O, Duarte GV. Psoriasis: classical and emerging comorbidities. An Bras Dermatol. 2015;90(1):9-20. doi:10.1590/abd1806-4841.20153038
3. Grant C, Woodbury M, Skougaard M, et al. Sleep Problems in Patients With Psoriatic Arthritis: A Systematic Literature Review and Metaanalysis. J Rheumatol. Published online May 1, 2023. doi:10.3899/jrheum.2022-1169