{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:10:22Z","timestamp":1788887422226,"version":"build-2803163510"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Sleep disorders trigger the hormonal imbalance and the accumulation of reactive oxygen molecules which are involved in melasma pathogenesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives:<\/jats:title>\n                    <jats:p>This study aims to assess the potential relationship between melasma and sleep components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>One hundred patients with melasma and 100 sex- and age-matched healthy controls aged over 18 were included. The melasma area severity index (MASI) and melasma quality of life (MelasQoL) scores of the patients were calculated. The Pittsburg Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were applied to patients with melasma and healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Compared with the controls, the median PSQI and ESS total scores were higher in the melasma patients. The patients with melasma reported impaired sleep components more frequently than the healthy controls. The rate of cases with excessive daytime sleepiness was similar between the patients and the controls. The analysis did not reveal any statistically significant correlation between MASI, MelasQoL, and the two questionnaires for melasma patients. In the multivariate analyses, the following factors were found to affect melasma: subjective sleep quality score (OR: 2.49, 95%CI: 1.26\u20134.89); sleep latency score (OR: 2.16, 95%CI: 1.34\u20133.49), sleep disturbances score (OR: 2.78, 95%CI: 1.17\u20136.57), Fitzpatrick skin type (OR: 1.88, 95% CI: 1.15\u20133.07), and total ESS score (OR: 1.13, 95% CI: 1.04\u20131.23).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study\u2019s findings suggest impaired subjective sleep quality, prolonged sleep onset latency, and sleep disturbances may affect melasma. Dermatologists should consider the potential benefits of improving sleep hygiene and treating sleep disorders in melasma patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijd.ijd_879_24","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T05:00:11Z","timestamp":1759986011000},"page":"348-353","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Is Impaired Sleep Quality a Triggering Factor in Melasma Patients? A Cross-Sectional Study"],"prefix":"10.4103","volume":"71","author":[{"given":"Ceylan","family":"Avc\u0131","sequence":"first","affiliation":[{"name":"From the Department of Dermatology and Venereology, Faculty of Medicine, Dokuz Eyl\u00fcl University, \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fclfem","family":"Ak\u0131n","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology and Venereology, Faculty of Medicine, Dokuz Eyl\u00fcl University, \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevgi","family":"Akarsu","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology and Venereology, Faculty of Medicine, Dokuz Eyl\u00fcl University, \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turna","family":"\u0130lknur","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology and Venereology, Faculty of Medicine, Dokuz Eyl\u00fcl University, \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"R1-20260908","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/phpp.12783","article-title":"Melasma: The need for tailored photoprotection to improve clinical outcomes","volume":"38","author":"Morgado-Carrasco","year":"2022","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"R2-20260908","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s13555-017-0194-1","article-title":"Melasma: An up-to-date comprehensive review","volume":"7","author":"Ogbechie-Godec","year":"2017","journal-title":"Dermatol Ther (Heidelb)"},{"key":"R3-20260908","first-page":"124","article-title":"Melasma: \u0130nsights and perspectives","volume":"18","author":"Jadotte","year":"2010","journal-title":"Acta Dermatovenerol Croat"},{"key":"R4-20260908","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3109\/15569527.2013.834496","article-title":"Oxidative stress status in patients with melasma","volume":"33","author":"Se\u00e7kin","year":"2014","journal-title":"Cutan Ocul Toxicol"},{"key":"R5-20260908","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/ijd.13695","article-title":"Role of oxidative stress in melasma: A prospective study on serum and blood markers of oxidative stress in melasma patients","volume":"56","author":"Choubey","year":"2017","journal-title":"Int J Dermatol"},{"key":"R6-20260908","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1111\/jocd.15924","article-title":"Evaluation of systemic oxidative stress in patients with melasma","volume":"23","author":"Rahimi","year":"2024","journal-title":"J Cosmet Dermatol"},{"key":"R7-20260908","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.3390\/antiox12111969","article-title":"Oxidative stress \u0131nduces skin pigmentation in melasma by \u0131nhibiting hedgehog signaling","volume":"12","author":"Kim","year":"2023","journal-title":"Antioxidants (Basel)"},{"key":"R8-20260908","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/bs.apcsb.2019.03.001","article-title":"Sleep deprivation, oxidative stress and inflammation","volume":"119","author":"Atrooz","year":"2020","journal-title":"Adv Protein Chem Struct Biol"},{"key":"R9-20260908","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5334\/jcr.190","article-title":"Sleep and reproductive health","volume":"18","author":"Lateef","year":"2020","journal-title":"J Circadian Rhythms"},{"key":"R10-20260908","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/jocd.12877","article-title":"Melasma: How hormones can modulate skin pigmentation","volume":"18","author":"Filoni","year":"2019","journal-title":"J Cosmet Dermatol"},{"key":"R11-20260908","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1001\/archderm.1994.01690060057005","article-title":"Topical retinoic acid (tretinoin) for melasma in black patients. 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