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

Lupus ◽  
2014 ◽  
Vol 23 (13) ◽  
pp. 1350-1357 ◽  
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.

scholarly journals Association between depression and sleep quality in patients with systemic lupus erythematosus: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Rulan Yin ◽  
Lin Li ◽  
Lan Xu ◽  
Wenjie Sui ◽  
Mei’e Niu ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Sleep Quality ◽  
Lupus Erythematosus ◽  
Sleep Disturbances ◽  
Cochrane Library ◽  
Poor Sleep ◽  
Moderate Correlation ◽  
Systemic Lupus ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality

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.

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

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

Predictors of poor sleep quality in patients with systemic lupus erythematosus

2017 ◽  
Vol 36 (5) ◽  
pp. 1053-1062 ◽  
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

scholarly journals FRI0178 PREDICTIVE FACTORS FOR POOR SLEEP QUALITY IN SYSTEMIC LUPUS ERYTHEMATOSUS

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

Which Factors Are the Most Important for Predicting Sleep Quality in Obstructive Sleep Apnea Patients with Obesity?

2019 ◽  
Vol 81 (3-4) ◽  
pp. 190-196
Author(s):  
Byung Joon Kim ◽  
Kang Min Park
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Control Group ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Obstructive Sleep ◽  
N Stage ◽  
Improve Sleep Quality

Background: Both obstructive sleep apnea (OSA) and obesity are associated with poor sleep quality. However, there have been no studies investigating sleep quality in OSA patients with obesity. The aims of this study were to (1) evaluate the sleep quality in OSA patients with obesity and (2) identify the parameters most related to sleep quality in OSA patients with obesity. Methods: Of the patients with polysomnography (PSG), OSA patients with obesity (body mass index [BMI] ≥25) were enrolled and then divided into 2 groups based on the Pittsburg Sleep Questionnaire Index (PSQI): patients with good sleep quality (PSQI ≤5, good sleepers) and those with poor sleep quality (PSQI >5, poor sleepers). In addition, we enrolled OSA patients without obesity as a disease control group. Results: Eighty-two OSA patients with obesity met the inclusion criteria (28 were good sleepers, whereas 54 were poor sleepers). We found that the BMI of the poor sleepers was significantly higher than that of the good sleepers, whereas the N-stage sleep ratio of good sleepers was higher than that of poor sleepers. Logistic ­regression analysis also showed that a high BMI and low ­N-stage sleep ratio were independently associated with poor sleep quality. In addition, BMI and N-stage sleep ratio were significantly correlated with PSQI. However, in 56 OSA patients (n = 56) without obesity, there were no differences of demographic/clinical characteristics and PSG parameters between the good (n = 18) and poor sleepers (n = 38). Discussions: About two-thirds of OSA patients with obesity show poor sleep quality. The sleep quality of these patients was more affected by the severity of obesity, but not the severity of OSA. Thus, we recommend weight loss in OSA patients with obesity to improve sleep quality as well as the severity of OSA.

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

Lupus ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 454-460 ◽  
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.

scholarly journals Refreshing Sleep and Sleep Continuity Determine Perceived Sleep Quality

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Eva Libman ◽  
Catherine Fichten ◽  
Laura Creti ◽  
Kerry Conrod ◽  
Dieu-Ly Tran ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Qualitative Methodology ◽  
Control Group ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Therapeutic Success ◽  
Sleep Continuity ◽  
Outcome Criterion ◽  
Obstructive Sleep ◽  
Research Outcome

Sleep quality is a construct often measured, employed as an outcome criterion for therapeutic success, but never defined. In two studies we examined appraised good and poor sleep quality in three groups: a control group, individuals with obstructive sleep apnea, and those with insomnia disorder. In Study 1 we used qualitative methodology to examine good and poor sleep quality in 121 individuals. In Study 2 we examined sleep quality in 171 individuals who had not participated in Study 1 and evaluated correlates and predictors of sleep quality. Across all six samples and both qualitative and quantitative methodologies, the daytime experience of feeling refreshed (nonrefreshed) in the morning and the nighttime experience of good (impaired) sleep continuity characterized perceived good and poor sleep. Our results clarify sleep quality as a construct and identify refreshing sleep and sleep continuity as potential clinical and research outcome measures.

Sleep quality in caregivers of patients with Alzheimer's disease and Parkinson's disease and its relationship to quality of life

2012 ◽  
Vol 24 (11) ◽  
pp. 1827-1835 ◽  
Author(s):  
Chiara Cupidi ◽  
Sabrina Realmuto ◽  
Gianluca Lo Coco ◽  
Antonio Cinturino ◽  
Simona Talamanca ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

ABSTRACTBackground: Knowledge about sleep complaints of caregivers of patients with Alzheimer's disease (AD) and Parkinson's disease (PD) is limited, and we lack information about the relationship between caregivers’ sleep problems and their quality of life (QoL).Methods: We evaluated subjective sleep quality and its relationship to QoL in a group of 80 caregivers of patients with AD (ADCG, n = 40) and PD (PDCG, n = 40), and in 150 controls. Information about night-time complaints was collected using the Pittsburgh Sleep Quality Index (PSQI). QoL was measured using the McGill QoL Questionnaire.Results: Eighteen ADCG (45%), 22 PDCG (55%), and 45 (30%) controls reported poor sleep quality. Mean global PSQI score of PDCG (6.25 ± 3.9) was not significantly different from that of ADCG (5.8 ± 3.5; p = 0.67). However, both PDCG and ADCG scored significantly higher than control group (4.3 ± 3.1; p < 0.01). ADCG frequently reported difficulties falling asleep (72.5%) and disturbed sleep (100%). PDCG reported reduced subjective sleep quality (80%) and increased sleep disturbances (100%). Poor sleep quality was associated with depressive symptoms and correlated with QoL in caregivers of both groups, particularly the psychological symptoms domain.Conclusions: Among caregivers of patients with AD and PD, poor sleep quality is frequent and significantly linked to QoL and depressive symptoms. Identifying the nature of sleep disturbances not only in patients but also in their caregivers is important as appropriate treatment may lead to a better management of the needs of families coping with these patients.

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

SLEEP ◽  
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 &lt;.001). On average, pain negatively predicted TST (p &lt;.05) and diary SQ (p &lt;.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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