Predictors of poor sleep quality in patients with systemic lupus erythematosus

Abstract Background Currently, there is no consistent understanding of the relationship between depression and sleep quality in patients with systemic lupus erythematosus (SLE). This study aimed to explore the correlation between depression and sleep quality in SLE patients. Methods Five English (PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL) databases were systematically searched from inception to January 12, 2021. Two authors independently screened publications and extracted data according to set inclusion and exclusion criteria. Statistical analyses were performed with STATA 16.0. Data were pooled using a random-effects model. Results A total of 9 identified studies matched the inclusion criteria, reporting on 514 patients with SLE in the analysis. A moderate correlation of depression with sleep quality was found (pooled r = 0.580 [0.473, 0.670]). Compared to good sleepers, patients with SLE and poor sleep quality had higher levels of depression (standardized mean difference = − 1.28 [− 1.87, − 0.69]). Depression was associated with subjective sleep quality (r = 0.332 [0.009, 0.592]), sleep latency (r = 0.412 [0.101, 0.649]), sleep disturbances (r = 0.405 [0.094, 0.645]), daytime dysfunction (r = 0.503 [0.214, 0.711]), the four dimensions of Pittsburgh Sleep Quality Index (PSQI), while no significant correlation was found in the other three PSQI dimensions. Conclusion Depression had a moderate correlation with sleep quality in patients with SLE. Patients with poor sleep quality tended to have higher level of depression than that of good sleepers. Awareness of the correlation may help rheumatology physicians and nurses to assess and prevent depression and improve sleep quality in patients with SLE.

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Poor sleep quality in systemic lupus erythematosus: does it depend on depressive symptoms?

Lupus ◽

10.1177/0961203314540762 ◽

2014 ◽

Vol 23 (13) ◽

pp. 1350-1357 ◽

Cited By ~ 22

Author(s):

L Palagini ◽

C Tani ◽

R M Bruno ◽

A Gemignani ◽

M Mauri ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Depressive Symptoms ◽

Sleep Quality ◽

Lupus Erythematosus ◽

Sleep Disturbances ◽

Control Group ◽

Poor Sleep ◽

Systemic Lupus ◽

Poor Sleep Quality ◽

Obstructive Sleep

Objectives Sleep disturbances are frequently observed in rheumatic diseases including systemic lupus erythematosus (SLE). This study aimed at evaluating the prevalence of insomnia, poor sleep quality and their determinants in a cohort of SLE patients. Methods Eighty-one consecutive SLE female patients were evaluated in a cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Beck Depression Inventory (BDI) and the Self-rating Anxiety Scale (SAS) were administered. Patients with previous diagnosis of obstructive sleep apnea or restless legs syndrome were excluded. Fifty-three women with hypertension (without SLE) were enrolled as control group (H). Results In the SLE cohort poor sleep quality (65.4% vs 39.6%, p < 0.01) and difficulty in maintaining sleep and/or early morning awakening (65.4% vs 22.6%, p < 0.001), but not insomnia (33.3% vs 22.6%, p = ns), were more prevalent than in H. Depressive symptoms were present in 34.6% of SLE vs 13.2% H patients ( p < 0.001) while state anxiety was more common in H patients (H 35.8% vs SLE 17.3%, p < 0.005). SLE was associated with a 2.5-times higher probability of presenting poor sleep quality in comparison to H (OR 2.5 [CI 1.21–5.16]). After adjusting for confounders, both depressive symptoms (OR 4.4, [1.4–14.3]) and use of immunosuppressive drugs (OR 4.3 [CI 1.3–14.8]) were significantly associated with poor sleep quality in SLE patients. Furthermore, poor sleep quality was not associated either with disease duration or activity. Conclusions In a cohort of SLE women, insomnia and poor sleep quality, especially difficulties in maintaining sleep, were common. Depressive symptoms might be responsible for the higher prevalence of poor sleep quality in SLE.

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Erratum to: Predictors of poor sleep quality in patients with systemic lupus erythematosus

Clinical Rheumatology ◽

10.1007/s10067-017-3661-2 ◽

2017 ◽

Vol 36 (7) ◽

pp. 1697-1698

Author(s):

M. Inoue ◽

K. Shiozawa ◽

R. Yoshihara ◽

T. Yamane ◽

Y. Shima ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Sleep Quality ◽

Lupus Erythematosus ◽

Poor Sleep ◽

Systemic Lupus ◽

Poor Sleep Quality

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FRI0178 PREDICTIVE FACTORS FOR POOR SLEEP QUALITY IN SYSTEMIC LUPUS ERYTHEMATOSUS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.931 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 673.2-673

Author(s):

R. Magro ◽

L. Camilleri ◽

A. Borg

Keyword(s):

Systemic Lupus Erythematosus ◽

Sleep Quality ◽

Predictive Factors ◽

Lupus Erythematosus ◽

Quality Index ◽

Functional Disability ◽

Pittsburgh Sleep Quality Index ◽

Poor Sleep ◽

Systemic Lupus ◽

Poor Sleep Quality

Background:Poor sleep quality is common in systemic lupus erythematosus (SLE) and could contribute to fatigue, which is regarded as one of the most disabling symptoms in SLE. The Pittsburgh sleep quality index (PSQI) is a validated self-administered questionnaire that measures sleep quality over the previous month.1Objectives:The aim of this study was to analyse the relationship of sleep quality with several variables including depression, anxiety, pain, disease activity, fatigue and functional disability in patients with SLE. A further aim was to establish the prevalence of poor sleep quality in SLE.Methods:A cohort cross-sectional study was carried out including 92 SLE patients who fulfilled the SLICC classification criteria for SLE and who provided informed consent for participation. The patients were interviewed and they were asked to fill in questionnaires including PSQI, Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), visual analogue scale (VAS) for pain and modified Health Assessment Questionnaire (mHAQ). Blood and urine tests enabled the calculation of SLE disease activity index-2K (SLEDAI-2K). The study was approved by the University Research Ethics Committee.Results:92.4% of the cohort studied were females, and the mean age was 46.9 years (range 19-79 years). 55.4% were noted to have poor quality sleep (PSQI >5), and the median PSQI was 6 (range 0-18). Sleep quality measured by PSQI, had a significant correlation with SLEDAI-2K (R=0.254, p=0.014), VAS pain (R=0.515, p<0.001), HADS-D (R=0.605, p<0.001), HADS-A (R=0.375, p<0.001), estimated glomerular filtration rate (eGFR) (R=-0.211, p=0.044), FSS (R=0.551, p<0.001) and mHAQ (R=0.559, p<0.001). ANCOVA analysis showed that PSQI was significantly dependant on VAS pain (p<0.001), HADS-D (p<0.001) and eGFR (p=0.003).Conclusion:Poor sleep quality is highly prevalent in SLE patients. This study has shown that the strongest predictive factors for poor sleep quality are pain, depression and impaired renal function. Since poor sleep quality is significantly related to fatigue and functional disability, its identification and management is important for patients’ wellbeing.References:[1]Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28: 193 – 213.Disclosure of Interests:None declared

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Illness perception is significantly determined by depression and anxiety in systemic lupus erythematosus

Lupus ◽

10.1177/0961203317751858 ◽

2018 ◽

Vol 27 (3) ◽

pp. 454-460 ◽

Cited By ~ 11

Author(s):

K Nowicka-Sauer ◽

A Hajduk ◽

H Kujawska-Danecka ◽

D Banaszkiewicz ◽

Ż Smoleńska ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Sleep Quality ◽

Lupus Erythematosus ◽

Psychological Intervention ◽

Illness Perception ◽

Visual Analogue Scale Pain ◽

Anxiety And Depression ◽

Poor Sleep ◽

Systemic Lupus ◽

Anxiety Depression

Objectives Illness perception is a cognitive representation influencing physical and psychological functioning and adherence in patients with rheumatic disease. Studies exploring illness perception in systemic lupus erythematosus (SLE) are still scarce and none of them have investigated factors determining illness perception. We aimed to assess illness perception and to identify psychological, clinical and sociodemographic factors that might influence illness perception in SLE. Methods The study involved 80 patients with SLE (87.5% women, mean age 41.56 years). The Brief Illness Perception Questionnaire, State Trait Anxiety Inventory, Beck Depression Inventory, Pittsburgh Sleep Quality Index, Visual Analogue Scale-Pain and Fatigue Severity Scale were used. Clinical and sociodemographic data were collected via structured interview and medical files review. Results Illness perception was significantly positively correlated with anxiety, depression, sleep quality, fatigue and pain while it was not related to age, education, steroid treatment, disease duration and activity (SLEDAI) or organ damage (SLICC/ACR). Regression analysis revealed that state anxiety and depression explained 43% of illness perception variance. Cluster analysis identified three patient groups among which the middle-aged group had the most negative illness perception, the highest levels of anxiety, depression, pain and fatigue, and the poorest sleep quality. Conclusions The study has proved a significant relationship between negative illness perception and anxiety and depression. Patients reporting fatigue, poor sleep and pain might have special needs in terms of psychological intervention focused on negative illness perception and distress symptoms. Multidisciplinary care in managing SLE seems to be of great importance.

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587 Temporal Daily Relationships Between Sleep Deficiency and Pain in Youth with Systemic Lupus Erythematosus

SLEEP ◽

10.1093/sleep/zsab072.585 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A231-A232

Author(s):

Dahee Wi ◽

Teresa Ward

Keyword(s):

Systemic Lupus Erythematosus ◽

Sleep Quality ◽

Lupus Erythematosus ◽

Autoimmune Disorder ◽

Sleep Time ◽

Poor Sleep ◽

Systemic Lupus ◽

Pubertal Stage ◽

Sleep Deficiency ◽

The Mean

Abstract Introduction Systemic Lupus Erythematosus (SLE) is a chronic, inflammatory autoimmune disorder characterized by recurrent episodes of pain and is more prevalent in youth of color. Although sleep deficiency (poor quality and an inadequate amount of sleep) and pain are interrelated, most of what is known about SLE pain and sleep rely on reports from adults. Less is known about these associations in youth with SLE, leaving a critical gap in care for this population. This study aims to describe the temporal daily relationships between sleep deficiency and pain in 11-to 18-year-old youth with SLE. Methods Twenty-three youth (n=21 girls, n=9 Hispanic) with SLE (mean age=14.7 □ 2.2) participated in the study. Youth wore actigraphy and completed electronic sleep diaries for consecutive 10 days. Actigraphic sleep variables (Total Sleep Time [TST], Sleep Efficiency [SE]) and self-reported Sleep Quality (diary SQ) were examined as predictors of next-day pain in the morning. Average daytime pain was examined as a predictor of nighttime sleep (both actigraphic and self-reported sleep variables). Pubertal stage and ethnicity (Hispanic vs. Non-Hispanic) were entered as covariates in all models. Results Of the sample, the mean TST was 7 □ 1.2 hours and the mean SE was 73.5 □ 9.2% as measured by actigraphy. On average, diary SQ negatively predicted next-day pain in the morning (p <.001). On average, pain negatively predicted TST (p <.05) and diary SQ (p <.001). The within-subject relationships between sleep and next-day pain were not significant. Daytime pain predicted neither actigraphic nor self-reported sleep quality. Conclusion Poor sleep is a modifiable behavior, and improving sleep quality may reduce pain intensity in youth with SLE. Although further study is needed, the findings suggest that sleep is a potential target for interventions to alleviate symptoms of pain in this population. Support (if any) This work was funded by NIH/NINR P30NR016585 (MPI: MMH, TMW), R21NR017471 (TMW); University of Washington, School of Nursing, Research and Intramural Funding (RIFP); Hester McLaws Nursing Scholarship.

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Hubungan Derajat Penyakit Terhadap Kualitas Tidur Pasien Systemic Lupus Erythematosus Di Komunitas Odapus Lampung

MAHESA : Malahayati Health Student Journal ◽

10.33024/mahesa.v1i4.3992 ◽

2021 ◽

Vol 1 (4) ◽

pp. 461-470

Author(s):

Festy Ladyani Mustofa ◽

Fitra Editama

Keyword(s):

Systemic Lupus Erythematosus ◽

Sleep Quality ◽

Lupus Erythematosus ◽

Bivariate Analysis ◽

P Value ◽

Poor Sleep ◽

Systemic Lupus ◽

Chi Square ◽

Cross Sectional ◽

The Relationship

ABSTRACT: RELATIONSHIP OF SLEEP DISEASE TO SLEEP QUALITY OF SYSTEMIC LUPUS ERYTHEMATOUS PATIENTS IN ODAPUS COMMUNITY LAMPUNGBackground: Systemic Lupus Erythematosus (SLE) is a disease that attacks the immune system that has no known cause and which can damage various organs of the human body. The clinical symptoms of SLE patients depend largely on the area of the organs involved. Symptoms of SLE are classified into three degrees, namely mild, moderate, and severe. Based on the evaluation of SLE disease activity, patients with SLE may experience sleep disturbances. So the authors conducted a study examining the relationship between degrees of disease and sleep quality. Objective: To determine the relationship between the degree of disease and the sleep quality ofpatients systemic lupus erythematosus in the ODAPUS community in Lampung 2020. Research Methods: this type of research is an observational analytic study with primary data using a questionnaire with aapproach cross-sectional. The sample of this study was all 40 patients who joined the ODAPUS community in Lampung. Data analysis used univariate and bivariate analysis using tables in data presentation. Results: From the results of the bivariate analysis, it is known that there is a significant relationship between the degree of disease and the sleep quality ofpatients systemic lupus erythematosus in the ODAPUS Lampung 2020 community. This is evidenced by thetest Chi Square with a P value of 0.008 with (α) = 5% then P <0.05. Also obtained an OR 11,625 (95% CI 1,467-92,139), which means that respondents with a severe disease degree were 11.625 times more likely to have poor sleep quality than those with mild disease degrees. Conclusion: There is a relationship between the degree of disease and the sleep quality ofpatients systemic lupus erythematosus in the ODAPUS community in Lampung 2020. Keywords: Disease Degree, Sleep Quality, SLE INTISARI: HUBUNGAN DERAJAT PENYAKIT TERHADAP KUALITAS TIDUR PASIEN SYSTEMIC LUPUS ERYTHEMATOSUS DI KOMUNITAS ODAPUS LAMPUNG Latar Belakang: Systemic Lupus Erythematosus (SLE) merupakan penyakit yang menyerang sistem kekebalan tubuh yang tidak dapat diketahui penyebabnya dan yang dapat merusak berbagai organ tubuh manusia. Gejala klinis dari pasien SLE sangat bergantung pada daerah organ yang terlibat. Gejala SLE dikelompokan menjadi tiga derajat yaitu ringan, sedang, dan berat. Berdasarkan evaluasi pada aktivitas penyakit SLE, pasien penderita SLE dapat mengalami gangguan tidur. Sehingga penulis melakukan penelitian yang mengkaji tentang hubungan derajat penyakit terhadap kualitas tidur.Tujuan: Untuk mengetahui hubungan antara derajat penyakit terhadap kualitas tidur pasien systemic lupus erythematosus di komunitas ODAPUS Lampung 2020.Metode Penelitian: Jenis penelitian ini adalah analitik observasional dengan data primer menggunakan kuesioner dengan pendekatan Cross- sectional. Sampel penelitian ini adalah seluruh pasien yang bergabung di komunitas ODAPUS Lampung sebanyak 40 orang. Analisis data menggunakan analisis univariat dan bivariat dengan menggunakan tabel dalam penyajian data.Hasil: Dari hasil analisis bivariat diketahui bahwa adanya hubungan yang bermakna antara derajat penyakit terhadap kualitas tidur pasien systemic lupus erythematosus di komunitas ODAPUS Lampung 2020. Hal ini dibuktikan berdasarkan uji Chi Square dengan nilai P value sebesar 0,008 dengan (α) = 5% maka P < 0,05. Diperoleh pula OR 11,625 (95% CI 1,467-92,139) yang berarti bahwa responden dengan derajat penyakit berat berpeluang 11,625 kali lebih besar memiliki kualitas tidur yang buruk dibandingkan dengan derajat penyakit yang ringan.Kesimpulan: Adanya hubungan antara derajat penyakit terhadap kualitas tidur pasien systemic lupus erythematosus di komunitas ODAPUS Lampung 2020. Kata Kunci : Derajat Penyakit, Kualitas Tidur, SLE

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