Psoriatic and psoriatic arthritis patients with and without jet-lag: does it matter for disease severity scores? Insights and implications from a pilot, prospective study.

Background: Jet-lag may affect air-travelers crossing at least two time-zones and has several health-care implications. It occurs when the human biological rhythms are out of synch with respect to the day-night cycle at the country destination. Its effect in psoriasis is missing. We aimed to evaluate the effect of Jet-lag in psoriatic patients' management. Methods: This is a prospective observational study that enrolled psoriatic patients that underwent a flight: patients who experienced jet-lag were compared to patients who did not experience jet-lag. Before the flight, a dermatologist recorded clinical and demographical data with particular attention to Psoriasis Area Severity Index (PASI) and Disease Activity in Psoriatic Arthritis (DAPSA). Patients performed Self-Administered Psoriasis Area Severity Index (SAPASI), the Dermatology Life Quality Index (DLQI) and the pruritus Visual Analog Scale (VAS) scores. After the flight, patients completed the SAPASI, DLQI and pruritus-VAS scores. Results: The sample recruited comprised of 70 psoriatic patients aged 42.4 ± 9.7 years (median 42.5 years). Thirty (42.9%) were males, mean BMI was 25.5 ± 2.2 kg/m2. Average disease duration was 15.2 ± 7.1 years, and 20 (28.6%) subjects had developed PsA. Average hours of flight were 5.4 ± 3.5 (median 3.5 h), with 34 (48.6%) subjects reporting jet-lag. At the multivariate regression analysis, the change in the SAPASI score resulted correlated with jet-lag (regression coefficient 1.63, p = .0092), as well the change in the DLQI score (regression coefficient = 1.73, p = .0009), but no change on the pruritus VAS scale was found. Conclusions: The present study suggests that jet-lag may influence disease severity and DLQI scores, but not itch in psoriatic patients.

Quality of sleep in Trinidad among the adult population

Objective: Sleep is a determinant of a positive life which is heavily influenced by the individual's lifestyle. The objectives of the study were to: (i) assess the quality of sleep among the Trinidad population and effects of associated demographics; (ii) assess the determinants of poor sleep quantity and quality; and (iii) evaluate participant's knowledge about sleep and importance of sleep. Design and Methodology: A cross-sectional study among the residents of Trinidad aged 18 and above was conducted from 18th May 2018 to 30th June 2018. Nonprobability convenience sampling was utilized to obtain information at public malls including: Trincity Mall, Gulf City Mall, Long Circular Mall, West mall and Valpark Mall. Results: 1505 participants were interviewed with 56.1% being poor sleepers while 43.9% were good sleepers. Participants over 40 years were found to have the lowest percentage of good sleepers. Diabetes Mellitus and sex were not found to be a significant determinant of sleep quality (p= 0.865; p=0.351 respectively). Employment status was associated with sleep quality (p <0.001). Night shift workers were more likely than other persons to report bad sleep quality was. Persons who lived in noisy areas and were also poor sleepers. Conclusion: The determinants of sleep quality in the adult Trinidad population were found to be older age, night shift workers and persons who lived in noisy areas or streets.