Background Sleep disturbances are frequently observed in systemic lupus erythematosus (SLE) patients, but the relationship with disease activity has not been unequivocally established.
Objectives To assess the prevalence of and factors associated with sleep disorders in a cohort of SLE patients with persistent complete (no clinical activity, no serological activity and no treatment other than antimalarials) or clinical remission (only serological activity; stable immunosuppressive therapy with or without corticosteroids allowed) (1).
Methods Consecutive adult SLE patients attending the outpatient clinic of the Second University of Naples were enrolled in a cross-sectional study. A complete clinical and laboratory assessment was carried out. Moreover, the Pittsburgh Sleep Quality Index (PSQI), Health Assessment Questionnaire – Disability Index (HAQ-DI), Short-Form 36 (SF-36), VAS pain, VAS fatigue, VAS global health, were administered.
Results Ninety SLE patients (86 females) with a mean±SD age of 43±18 and a median disease duration of 17 years (range 2–38) were enrolled in the study. A poor sleep quality (i.e. PSQI score>5) was observed in 38 (42.2%) patients, with no difference between patients in complete remission (13/30) and those in clinical remission with or without GCs (25/51; p=0.651). PSQI score was found to be significantly correlated with physical component score of SF-36 (rho -0.467, 95% CI -0.632 to -0.262; p<0.0001), mental component score of SF-36 (rho -0.501, 95% CI -0.657 to -0.303; p<0.0001), HAQ-DI (rho 0.497, 95% CI 0.303 to 0.651; p<0.0001), VAS pain (rho 0.480, 95% CI 0.283 to 0.639; p<0.0001), VAS fatigue (rho 0.491, 95% CI 0.296 to 0.697; p<0.0001). No correlation was found between the physician assessment of disease activity and sleep disturbance (rho 0.113, 95% CI -0.114 to 0.128; p=0.329).
Conclusions Sleep disorders are frequent in SLE patients with persistent complete or clinical remission. An impaired mental and physical quality of life, disability, fatigue and pain represent the main features associated with a low quality of sleep.
Zen M, et al. Prolonged remission in Caucasian patients with SLE: prevalence and outcomes. Ann Rheum Dis 2015;74:2117–22
Disclosure of Interest None declared