Evaluation of Sleep Disorders and Quality of Life in Patients With Mycosis Fungoides.
Seyed AmirReza Mohammadi, Mozhdeh Sepaskhah, Arvin Hedayati, Ladan Dastgheib, Soheila Khodakarim, Mohammad Amin Gholami
Abstract
Open AccessBACKGROUND: Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma, presenting with variable clinical features that can be pruritic. Pruritus and the overall disease burden may disrupt sleep and diminish quality of life; yet, sleep disturbances in MF remain under-investigated. AIMS: To evaluate sleep quality and quality of life in MF patients compared with healthy controls. METHODS AND RESULTS: In a cross-sectional, case-control study at a referral clinic in Shiraz, Iran, 78 MF patients (TNMB stages IA-IIIA) and 76 age- and sex-matched controls completed the Pittsburgh Sleep Quality Index (PSQI), the 12-Item Short Form Survey (SF-12), and the Hospital Anxiety and Depression Scale (HADS). MF patients had significantly poorer sleep quality, with 62.8% reporting poor sleep quality compared to 27.6% of controls (p < 0.001). Among MF patients, poorer sleep quality was significantly associated with greater pruritus intensity, more advanced disease stage, and a higher modified severity-weighted assessment tool score (mSWAT) (all p < 0.05). In contrast, histopathological subtype and treatment modality showed no significant association. MF patients exhibited higher rates of moderate-to-severe anxiety (34.6% vs. 15.8%) and depression (30.7% vs. 14.6%) (p < 0.05). Physical health scores on the SF-12 were significantly lower in the MF group (p < 0.01), whereas the decrease in mental health scores did not reach significance. CONCLUSION: MF is associated with significant sleep dysfunction, psychological distress, and impaired physical quality of life. Pruritus intensity, disease stage, and cutaneous disease burden are key contributors to poor sleep quality. Larger studies are warranted to further elucidate the extent and mechanisms of sleep disturbance in this population.