Sleep quality, clinical and psychological manifestations in women with systemic lupus erythematosus

• Published in: International journal of rheumatic diseases Vol. 20; no. 10; pp. 1541 - 1550
• Main Authors: Moraleda, Virginia, Prados, Germán, Martínez, María P., Sánchez, Ana I., Sabio, José M., Miró, Elena
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-10-2017
• Subjects: Actigraphy; Adolescent; Adult; Aged; Anxiety; Anxiety - diagnosis; Anxiety - etiology; Anxiety - psychology; Case-Control Studies; Chi-Square Distribution; Cost of Illness; Depression - diagnosis; Depression - etiology; Depression - psychology; Emotions; Fatigue; Female; Humans; Insomnia; Lupus; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - diagnosis; Lupus Erythematosus, Systemic - physiopathology; Lupus Erythematosus, Systemic - psychology; Mental depression; Mental Health; Middle Aged; objective sleep measures; Perception; Perceptions; Quality of Life; Risk Factors; Self Report; Sex Factors; Sleep; Sleep disorders; sleep quality; Sleep Wake Disorders - diagnosis; Sleep Wake Disorders - etiology; Sleep Wake Disorders - physiopathology; Stress, Psychological - diagnosis; Stress, Psychological - etiology; Stress, Psychological - psychology; Systemic lupus erythematosus; Young Adult; objective sleep measures; systemic lupus erythematosus; actigraphy; sleep quality
• ISSN: 1756-1841; 1756-185X
• DOI: 10.1111/1756-185X.13081

Aim
Sleep problems are a common complaint in systemic lupus erythematosus (SLE) patients. We analyzed sleep quality with subjective and objective measures in a sample with SLE and its possible relationships with the main manifestations of the disease.
Methods
Twenty‐one women with SLE and 20 healthy women participated in the study. All participants were evaluated with actigraphy for a week and they completed self‐report instruments of sleep quality, quality of life, fatigue, anxiety, depression and perceived stress. Comparison analyses between the two groups were done using Chi‐square and Student's t‐tests. The association between sleep quality and the remaining variables was explored using Pearson correlation coefficients.
Results
SLE patients had higher fragmentation index in the actigraphic analysis and a perception of poorer sleep quality, more fatigue, anxiety and depression than the control group. Bivariate analyses showed that the perception of more sleep disturbance and daytime dysfunction was associated with a lower health‐related quality of life, more fatigue, emotional discomfort and more perceived stress. Also, the fragmentation index in the actigraphy was significantly related to the perception of poorer quality of sleep.
Conclusion
SLE women had a poorer sleep quality (objective and subjective). These alterations could play a modulatory role in clinical and psychological manifestations of the disease and affect the quality of life in this population. More research is needed to clarify these relations and to determine the potential benefits of interventions directed to improve sleep in the clinical managing of the patients with SLE.