Dissatisfaction with cutaneous body image is directly correlated with insomnia severity: A prospective study in a non-clinical sample

Objectives: Sleep deprivation can physically affect skin appearance, e.g. increase the cutaneous signs of aging. There are no studies of sleep disorders and subjective ratings of skin appearance or cutaneous body image (CBI). CBI is an important consideration in the treatment of cosmetically disfiguring dermatologic disorders. We examined the association of insomnia and CBI. Methods: As part of a larger study, community-based non-clinical participants completed ratings of insomnia and CBI (also measured 4-weeks post-baseline) using the Cutaneous Body Image Scale (CBIS). Results: 301/311 adults (238 women; mean +/- SD age 38.6 +/- 14.7 years; 54.5% married; 94.2% "white") completed insomnia and CBI ratings at baseline; 243/301 completed CBI ratings 4-weeks post-baseline. A low CBIS score denotes greater dissatisfaction with CBI. Multiple regression analysis using CBI at baseline as dependent variable and insomnia, age and sex as independent variables revealed that insomnia (beta = -0.24, p<0.001) and female gender (beta = -0.25, p<0.001) but not age (beta = -0.097, p = 0.07) were predictors of CBI dissatisfaction (adjusted R-2 = 0.15, p<0.001). A similar relationship was observed for CBI ratings 4-weeks post-baseline. Conclusions: CBI dissatisfaction was positively related to insomnia severity, especially among women. Underlying insomnia may confound an individual's self-assessment of their CBI, a finding that has important treatment implications in dermatology.