Objective:
To compare jaw function and sleep quality among people with psoriasis, including by psoriatic arthritis (PsA) status and systemic treatment, and with healthy controls.
Approach:
- Design and participants: Prospective, controlled cross-sectional study of 105 patients with psoriasis and 73 age- and sex-matched controls.
- Measures: Jaw function was assessed with the JFLS-20, sleep quality with the PSQI, and skin disease severity with PASI. Analyses compared treatment groups and PsA status, with adjustment for specified demographic and disease factors.
Key Findings:
- Patients with PsA had higher mean JFLS-20 scores than those without PsA (0.80 vs. 0.45); PsA remained independently associated with greater jaw limitation in adjusted analyses.
- Overall, jaw limitation was not significantly greater in the psoriasis group than in controls. Mean JFLS-20 scores ranged from 0.51 to 0.59 across psoriasis treatment groups, compared with 0.52 in controls.
- Higher PASI scores were independently associated with poorer sleep quality, while biologic treatment status was associated with better sleep quality. PsA was not independently associated with sleep quality.
- Poor sleep quality was reported by 60% of patients receiving no systemic therapy and 60% receiving nonbiologic systemic therapy, compared with 7% receiving biologics and 10% of controls.
- Exploratory comparisons within the PsA group found lower mean jaw limitation and PSQI scores among biologic-treated patients, but could not establish that treatment caused these differences.
Interpretation:
The authors identified PsA-associated temporomandibular functional limitation as the study’s principal novel finding. Sleep quality was associated with skin disease severity and biologic treatment status in adjusted analyses.
Limitations:
- Single-center, cross-sectional design and relatively small sample.
- Patient-reported questionnaires were used without objective dental examinations, imaging, or sleep monitoring.
- Factors influencing sleep were not assessed in detail; exploratory subgroup comparisons were not adjusted for multiple testing.
- Lower disease activity among biologic-treated patients complicates interpretation of treatment associations.
- The biologic cohort excluded tumor necrosis factor inhibitors.
Conclusion:
The study authors reported no conflicts of interest.
Sources:
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