Poor sleep quality in systemic lupus eritematosus: does it depend on depression?

Abstract

Introduction Sleep disturbances are frequently observed in rheumatic diseases and significantly affect the quality of life of patients. The prevalence and characteristics of sleep disturbances in Systemic Lupus Erythematosus (SLE) are poorly studied. Objectives This study aimed at evaluating both prevalence of sleep disorders and sleep quality in a cohort of SLE women in comparison with patients suffering from a chronic disease as hypertension (H). In addition we explored determinants of sleep quality in SLE. Materials and methods In this cross-sectional study, 86 consecutive SLE women patients were evaluated from January 2012 through December 2012. 81 Have been recruited. 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 to all subjects. Poor sleep quality was defined as PSQI >5, insomnia as ISI >15, depressive symptoms as BDI >10, and trait anxiety as STAI-Y2 >40. Patients with other sleep disorders were excluded. Socio-demographic data were collected and a rheumatologic assessment was performed, including disease activity and damage scales, comorbidities and ongoing treatments. A control group of 53 H age matched women were also recruited. Results For the SLE cohort (mean age 44.0 ± 7.8 years; mean disease duration 15.5 ± 7.8 years, in disease remission) poor sleep quality resulted in 62.2% SLE patients versus 39.6% of H group (p Conclusion In this cohort of SLE women, insomnia and poor sleep quality were common. Especially poor sleep quality, difficulties in maintaining sleep and/or early morning awakening were more common in SLE than in H patients. In addition, depression was highly prevalent in SLE and was a major determinant of poor sleep quality.In addition poor sleep quality may be related to immunosuppressive therapy. These data highlight the importance of investigating sleep disorders, depressive symptoms and the role of therapy in SLE patients. Acknowledgements L. Carli, L. Ghiadoni.