This retrospective, matched‑cohort study evaluated the relationship between psoriasis severity and specific sleep disorders using the All of Us registry. A total of 7,743 adults with psoriasis were matched 1:4 by age, sex, and race/ethnicity to 30,972 controls. Psoriasis was classified as mild or moderate‑to‑severe based on clinical records.
Outcomes included restless leg syndrome, insomnia, and obstructive sleep apnea diagnoses, adjusted for sociodemographics and comorbidities. Mild psoriasis was significantly associated with restless leg syndrome, insomnia, and sleep apnea (all p < 0.05). These associations strengthened in moderate‑to‑severe disease, with risk estimates approximately 20–30% higher than in mild psoriasis. Moreover, non‑White patients exhibited disproportionately greater risk for insomnia and apnea compared with their White counterparts.
These results indicate that psoriasis regardless of severity, increases the risk for multiple sleep disorders, with greater disease severity and non‑White ethnicity further magnifying risk. However, reliance on electronic health record coding may introduce misclassification bias, and observational design precludes causal inference.
Therefore, prospective studies employing standardized sleep assessments are warranted to validate these findings and guide personalized management strategies.
