Sleep disturbance in adults with chronic pruritic dermatoses is associated with increased C-reactive protein levels

Sagar P. Patel, Raveena Khanna, Justin Choi, Kyle A. Williams, Youkyung S. Roh, Michael S. Hong, Nishadh H. Sutaria, Thomas Pritchard, Madan M. Kwatra, Shawn G. Kwatra

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Pruritus is a common symptom that can significantly reduce quality of life through sleep disruption. Objective: To examine features of disturbed sleep in patients with chronic pruritic dermatoses and test the hypothesis that systemic inflammation may serve as a biomarker for impaired sleep in these patients. Methods: Cross-sectional analysis of the National Health and Nutrition Examination Survey investigating systemic inflammation using C-reactive protein (CRP) levels. Logistic regression was used to compare patients with and without sleep disturbances, adjusting for demographics (model 1) and medical comorbidities (model 2). Results: Chronic pruritic dermatoses were associated with multiple sleep disturbances, including nighttime awakenings (model 1: odds ratio [OR], 1.646; 95% confidence interval [CI], 1.031-2.627; model 2: OR, 1.329; 95% CI, 0.888-1.989) and early morning awakening (model 1: OR, 1.669, 95% CI, 1.118-2.493; model 2: OR, 1.582; 95% CI, 1.008-2.481). Mean CRP levels were 52.8% higher among patients with pruritic dermatoses reporting trouble sleeping compared with those who did not (0.663 vs 0.434 mg/dL; P =.034). Trouble sleeping was also positively correlated with CRP levels (β = 0.142, P =.025). Limitations: Potential recall bias among participants. Conclusions: In addition to confirming sleep disturbances with pruritic dermatoses, we found these disturbances are more likely to present with elevated CRP levels. Clinicians should consider the potential risk for sleep-related and cardiac comorbidities in patients diagnosed with itchy skin conditions.

Original languageEnglish (US)
Pages (from-to)265-272
Number of pages8
JournalJournal of the American Academy of Dermatology
Issue number2
StatePublished - Feb 2021


  • C-reactive protein
  • biomarkers
  • dermatoses
  • eczema
  • inflammation
  • inflammatory
  • itch
  • pruritic
  • pruritic dermatoses
  • pruritus
  • sleep

ASJC Scopus subject areas

  • Dermatology


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