Rheumatology Medical News about systemic lupus erythematosus;sleep disturbances

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The prevalence and associations of sleep disturbances in patients with systemic lupus erythematosus
Modern Rheumatology, 06/19/09

Chandrasekhara PKS et al. – Data provide evidence that the prevalence of poor sleep quality in patients with systemic lupus erythematosus (SLE) was higher than it is generally perceived to be. Functional disability, disease activity and depressed mood contributed significantly to sleep disturbances.

Methods

An analysis of sleep complaints in pts with SLE and its prevalence and associations
In 50 outpatients, and age- and sex-matched controls:
- Sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI)
- Depressed mood, functional disability and pain severity using standardized questionnaires
- Disease severity, cumulative damage and presence of fibromyalgia by clinical examination
- Bivariate associations between sleep quality and disease-related variables and demographic variables
- Hierarchical regression analyses to determine the independent determinant of sleep quality

Results

PSQI scores were higher in pts; prevalence of sleep disturbance was 62%
Functional disability, disease activity and depressed mood correlated positively with sleep disturbances
36% of the pts satisfied ACR criteria for fibromyalgia
Multiple regression analyses: disease activity was an independent determinant of sleep quality

Exclusive Author Commentary
Pradeep Kumar Shenoy Chandrasekhara, 06/26/09

In the present study, it is documented that disease activity contributes to functional disability and depressed mood. Disease activity independently and along with depressed mood and functional disability contributed to disturbed sleep. Since SLE patients have higher incidence of disturbed sleep, it should be specifically looked into. Patients with higher cumulative damage and disease duration should be checked for the presence of fibromyalgia. The cause of fatigue in SLE should be specifically looked into. When the disease is in remission, the cause of fatigue in SLE could be depressed mood. In such patients, to manage fatigue antidepressants should be used and not the cytotoxic drugs. Since, disease activity was the independent determinant of sleep quality, to improve sleep in patients with SLE, physicians should always try to attain good control of disease activity, if not remission.

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