The prevalence and associations of sleep disturbances in patients with systemic lupus erythematosus

Abstract

The aim of this study was to analyze sleep complaints in patients with systemic lupus erythematosus (SLE) and to determine its prevalence and associations. Fifty outpatients with SLE and an equal number of age- and sex-matched controls were included in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) in both cases and controls. Depressed mood, functional disability and pain severity were assessed in patients using standardized questionnaires. Disease severity, cumulative damage and presence of fibromyalgia were determined by clinical examination. Bivariate associations between sleep quality and disease-related variables as well as demographic variables were calculated. A series of hierarchical regression analyses were computed to determine the independent determinant of sleep quality. PSQI scores were significantly higher in patients with SLE. Prevalence of sleep disturbance was 62%. Functional disability, disease activity and depressed mood correlated positively with sleep disturbances. 36% of the patients satisfied ACR criteria for fibromyalgia. In multiple regression analyses disease activity was found to be an independent determinant of sleep quality. The prevalence of poor sleep quality in patients with SLE was higher than it is generally perceived to be. Functional disability, disease activity and depressed mood contributed significantly to sleep disturbances in SLE.

Contributing factors and effects on health-related quality of life in patients with systemic lupus erythromatosus complaining of sleep disturbances

“…The results of this study are similar to previous studies reporting a prevalence of 55%-62% of sleep disturbances in patients with SLE. The study of Chandrasekhara et al [3] showed that SLE patients had more severe disturbances in almost all components of sleep quality than controls. While an association between SLE activity and sleep disturbance is expected, the results of previous studies have been different in this regard.…”

“…Some studies have shown an association between disease activity and subjective sleep disturbances [3,5] but other studies demonstrated no clear relationship in this regard [6,7]. There are also studies indicating a major role for psychological factors, mainly depression, for sleep disturbances in SLE patients, but other psychological disorders such as anxiety are less studied [2,3].…”

“…Although SLE can develop at any age, the highest incidence is found in young women with a peak onset between the ages of 20 and 40 years. The female-to-male gender ratio is 9:1 [2,3].…”

“…Sleep disturbances are common in patients with SLE. Studies with subjective sleep measures have shown that up to 80% of SLE patients have poor sleep quality [1][2][3][4]. Patients with systemic lupus have sleep problems, and anxiety and depression seem related to these sleep disturbances.…”

“…There are also studies indicating a major role for psychological factors, mainly depression, for sleep disturbances in SLE patients, but other psychological disorders such as anxiety are less studied [2,3].…”