To summarize and critically evaluate literature on the impact of chronic spontaneous urticaria (CSU) on sleep, including patient-reported sleep outcomes, sleep-disordered breathing (SDB), and biologic correlates associated with sleep disturbance.
Approach:
Search Strategy: A systematic literature search was conducted across multiple databases for studies related to CSU and sleep, focusing on human studies published in English.
Eligibility Criteria: Included studies evaluated sleep dysfunction in CSU patients, while excluding animal studies, non-peer-reviewed publications, and studies focusing on treatment effects rather than inherent sleep dysfunction.
Data Extraction: Data was extracted independently by three reviewers using a standardized form, capturing study design, participant characteristics, sleep assessment instruments, and biomarkers.
Key Findings:
Individuals with CSU report significant sleep disruption, which is associated with higher disease activity and lower quality of life.
Sleep disturbances in CSU are linked with psychological distress, fatigue, and systemic symptom burden.
Emerging evidence suggests a role for circadian–immune involvement and alterations in melatonin and orexin pathways in CSU patients.
Higher disease activity in CSU correlates with a greater burden of sleep-disordered breathing.
Interpretation:
Limitations:
Existing evidence on sleep dysfunction in CSU is dispersed across multiple study types and outcome domains.
Prior reviews have either lacked systematic methods or focused on broader dermatosis frameworks without specific attention to CSU.
Conclusion:
Sleep dysfunction is a significant component of the disease burden in CSU.
