Psoriasis, Sleep, and Mental Health: What’s the Connection?

From healthcentral.com

A new study has uncovered a strong link between psoriasis, REM disturbances, and depression—suggesting the condition is anything but skin deep 

If you have psoriasis and struggle to sleep at night, your issue might be more than skin deep. New research reveals a strong connection between psoriasis, sleep problems, and mental health—with each condition potentially worsening the others. Psoriasis itself causes an overactive immune system to produce inflammation and rapid skin cell build-up, leading to itchy, uncomfortable patches that can disrupt sleep. “Stress, injury to the skin, allergens, certain medications, even infections, can all trigger a psoriasis flare,” explains Veena Vanchinathan, M.D., a board-certified dermatologist at Kaiser Permanente in San Jose, CA who is not associated with the study. These same triggers often disturb sleep patterns as well, making sleep management just as important as traditional treatments for managing psoriasis effectively.

People With Psoriasis Sleep Poorly—and Feel Worse

In the recent study, presented at the American Academy of Dermatology Spring 2025 conference, Tina Bhutani, M.D., a board-certified dermatologist in private practice and volunteer faculty member at University of California, San Francisco, found that poor sleep doesn’t just cause daytime fatigue—it can amplify mental health issues and create a cycle of worsening psoriasis flares and increasing sleep disruption.

Dr. Bhutani and fellow UCSF researchers surveyed 487 people with psoriasis and 69 individuals without the condition, using validated questionnaires to assess sleep quality, depression, and anxiety. Psoriasis patients scored significantly worse across all measures—they had more trouble falling asleep, woke more frequently, experienced more insomnia symptoms, and showed higher depression and anxiety levels.

When examining the relationship between sleep and mental health specifically within the psoriasis group, the researchers found that even after adjusting for factors like disease severity or treatment, greater sleep impairment was significantly associated with anxiety and depression.

“Our results confirm the association between sleep quality and mental health in these patients,” says Dr. Bhutani. “But it’s not just that psoriasis patients tend to have sleep issues and mental health issues separately. The data shows the worse your sleep is, the more likely you are to also be experiencing anxiety and depression.”

Why Psoriasis Might Ruin Your Sleep

It makes sense that the itching and pain from psoriasis patches significantly impact sleep quality. Past research has shown that people with psoriasis are twice as likely to have sleep issues than the general population, with more than 85% of psoriasis patients reporting sleep difficulties. But physical discomfort isn’t the only culprit.

“There’s also research that suggests the heightened inflammatory process—the very thing driving the psoriasis—might interfere with the body’s sleep regulation system,” explains Dr. Bhutani.

Dr. Bhutani first became interested in this connection when one of her patient’s psoriasis dramatically improved after his sleep quality increased. “He had really tough to treat psoriasis and we had basically tried everything,” says Dr. Bhutani. “He came in one day and his skin was practically clear.” The patient’s wife had been treated for sleep apnoea, which had been disturbing both their sleep. Once she received treatment, both got better rest—and his psoriasis nearly disappeared. This case inspired Dr. Bhutani to investigate the sleep-psoriasis relationship further.

A Holistic Approach to Managing Skin Flares

The strong interconnection between psoriasis, sleep problems, and mental health suggests these aren’t simply co-occurring conditions—they’re actively influencing each other. Psoriasis symptoms directly interfere with sleep, and that lack of restorative rest takes a toll on mental health, creating what Dr. Bhutani calls “a potentially vicious cycle” of worsening skin, poorer sleep, and increasing depression and anxiety.

While more research is forthcoming, this study demonstrates why a holistic approach to psoriasis treatment is essential. “As dermatologists, we’re trained to treat skin diseases, but we also need to encourage our patients to seek help for sleep disorders, anxiety and depression, and other associated conditions, like cardiovascular disease and diabetes,” emphasises Dr. Bhutani.

Beyond medication, making lifestyle changes that improve overall health can have a big impact on your psoriasis. Eating better, exercising more, managing stress, and, yes, improving sleep quality can all lead to fewer flare ups, clearer skin, and a happier outlook on life.

If your psoriasis symptoms are keeping you awake, talk to your doctor about topical treatments that can help soothe the itch and inflammation. After that, make sleep a priority by keeping your bedroom cool and dark to encourage your body to fall asleep and sticking to a regular schedule. “A consistent sleep schedule, same bedtime, same wake up time—even on weekends, can help you get higher quality sleep,” says Dr. Bhutani.

https://www.healthcentral.com/news/psoriasis/psoriasis-sleep-and-mental-health-connection