Sleep quality in women with systemic lupus erythematosus: contributing factors and effects on health-related quality of life.

Abstract

Sleep quality disturbances are common in patients with systemic lupus erythematosus (SLE). We evaluated sleep quality and its contributors in women with SLE. Also we evaluated the effects of sleep quality disturbance on patients' health-related quality of life (HRQoL). Sleep quality was assessed in 77 women with SLE (age 36.5±10.1years) using the Pittsburgh Sleep Quality Index (PSQI). Disease activity and cumulative disease damage were assessed with standard indices. Patients completed the Hospital Anxiety and Depression Scale and LupusQoL. Univariate and multivariate analyses were performed to find contributors of poor sleep quality and association of sleep quality with HRQoL. Poor sleep quality was present in 44 patients (57.1%). Poor sleepers were older (P=0.015) and had higher body mass index (P=0.027) and more severe anxiety (P<0.001) and depression symptoms (P<0.007) compared with good sleepers. In the logistic regression model, age (β=1.16, P=0.006), disease activity (β=1.10, P=0.050), and anxiety/depression composite score (β=1.16, P=0.008) were independent contributors of poor sleep quality. Poor sleepers had impaired HRQoL in almost all domains of the LupusQoL than good sleepers (P<0.05). Poor sleep quality is common in women with SLE and significantly impairs their HRQoL. Age, disease activity and psychological factors were determinants of sleep quality in our study. Studies with objective sleep measures as well as interventional studies are warranted in this regard.