Sleep quality, disturbance and the prevalence of obstructive sleep apnoea in chronic spontaneous urticaria and associated risk factors

Background Chronic spontaneous urticaria (CSU) is a common dermatological disorder impairing quality of life. The impact of CSU on sleep quality and obstructive sleep apnoea remains unclear. Objective To estimate the prevalence of sleep disturbance and obstructive sleep apnoea (OSA) in CSU patients and identify associated risk factors. Methods We conducted an analytical cross-sectional study involving adult CSU patients (n = 327) per eligibility criteria. We used the Pittsburgh Sleep Quality Index (PSQI) and STOP-Bang questionnaires to evaluate sleep disturbance and risk for OSA, respectively. Furthermore, we evaluated disease characteristics, including urticaria control and laboratory parameters, and assessed their association with sleep disturbance and risk for OSA. Results Poor sleep quality was reported by 59.3% CSU patients, while 61.5% presented with intermediate-to-high risk for OSA. PSQI score showed a positive correlation with mean platelet volume (p = 0.03), and negative correlations with age (p = 0.01), BMI (p = 0.04) and the Urticaria Control Test (UCT) score (p = 0.01). The STOP-Bang score showed a positive correlation with age (p < 0.001), BMI (p < 0.001), UCT score (p = 0.008) and PLR (p < 0.001), while the absolute eosinophil count was negatively correlated (p = 0.0006). Symptomatic dermographism (OR 2.4) significantly increased the odds of poor sleep, while uncontrolled urticaria (OR 0.5) and dyslipidemia (OR 0.4) reduced its odds. Female gender (OR 12.3), uncontrolled urticaria (OR 2.7) and dyslipidaemia (OR 3.1) were significant positive predictors for moderate-to-severe risk for OSA. Conclusion CSU patients frequently experience disturbed sleep and are at risk for developing OSA. Awareness about these comorbidities is important to enable their early identification and appropriate management.