Sleep disturbance in alopecia areata: A cross‐sectional study

BACKGROUND: Alopecia areata (AA) is a nonscarring hair loss with autoimmune pathophysiology, which is associated with psychiatric disorders including anxiety and depression. Sleep disorders are commonly seen with anxiety and depression. Here we evaluate the sleep quality of AA patients. METHODS: This cross‐sectional study involved 51 AA patients and 51 age‐ and sex‐matched healthy controls. The sleep quality and day sleepiness were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires. The severity of AA was evaluated with the Severity of Alopecia Tool (SALT). RESULTS: Unlike the ESS score, the mean PSQI score was significantly higher in the AA group compared with the controls (7 ± 4.13 vs. 3.53 ± 1.96, p < 0.001). The number of cases with ESS ≥ 11, indicating the excess daytime sleepiness, was significantly higher in the AA group compared with controls (15 vs. 6, p = 0.02). There was no significant correlation between PSQI score and age, age of onset of the disease, or SALT score (p > 0.05). Anxiety and depression were more common in the AA group versus controls (p = 0.9). PSQI score was higher in AA patients who had anxiety and depression compared with those who did not (9.9 ± 5.28 vs. 4.76 ± 3.08, p = 0.001). CONCLUSION: Sleep quality is impaired in AA patients. As expected, sleep would be more disturbed in AA cases with depression or anxiety. Therefore, attention to sleep quality and concomitant psychiatric diseases is essential in AA clinical management.