Da Costa Deborah, Bernatsky Sasha, Dritsa Maria, Clarke Ann E, Dasgupta Kaberi, Keshani Anahita, Pineau Christian
McGill University Health Centre, Montreal, Quebec, Canada.
Arthritis Rheum. 2005 Apr 15;53(2):272-8. doi: 10.1002/art.21069.
To characterize sleep complaints in women with systemic lupus erythematosus (SLE) and to identify correlates of sleep quality.
Sleep quality in 100 women with SLE was assessed using the Pittsburgh Sleep Quality Index (PSQI). Participants completed standardized questionnaires assessing depressed mood, leisure time physical activity, functional disability, and pain severity. A clinical examination determined disease activity, cumulative damage, and whether patients fulfilled the American College of Rheumatology criteria for fibromyalgia. A series of hierarchical multiple regressions were computed.
The mean +/- SD global PSQI score was 6.98 +/- 4.03, with moderate to severe sleep impairment reported by 56% of the sample. The first model testing the importance of demographic factors was not statistically significant. In the disease-related model, the use of prednisone and functional disability both contributed to poor sleep quality (P < 0.001). The addition of level of exercise participation to the demographic set significantly added to the model (P = 0.001). Depression significantly added to the demographic set, explaining 29% of the variance (P < 0.0001). When these variables, along with disease related variables, were simultaneously regressed on the PSQI Global Score, only depressed mood appeared as a significant independent determinant of global sleep quality (P < 0.001). However, the point estimates for the Beta coefficients were consistent with effects for lack of exercise and prednisone use.
A significant proportion of women with SLE suffer from poor sleep quality. The findings suggest that depressed mood, prednisone use, and lack of exercise contribute to decreased overall sleep quality.
描述系统性红斑狼疮（SLE）女性患者的睡眠问题，并确定睡眠质量的相关因素。
使用匹兹堡睡眠质量指数（PSQI）评估100名SLE女性患者的睡眠质量。参与者完成了评估抑郁情绪、休闲时间身体活动、功能残疾和疼痛严重程度的标准化问卷。临床检查确定疾病活动度、累积损伤，以及患者是否符合美国风湿病学会纤维肌痛标准。进行了一系列分层多元回归分析。
PSQI全球平均得分±标准差为6.98±4.03，56%的样本报告有中度至重度睡眠障碍。检验人口统计学因素重要性的第一个模型无统计学意义。在疾病相关模型中，泼尼松的使用和功能残疾均导致睡眠质量差（P<0.001）。在人口统计学模型中加入运动参与水平后，模型有显著改善（P = 0.001）。抑郁情绪在人口统计学模型中有显著影响，解释了29%的方差（P<0.0001）。当将这些变量以及与疾病相关的变量同时对PSQI全球得分进行回归分析时，只有抑郁情绪是全球睡眠质量的显著独立决定因素（P<0.001）。然而，β系数的点估计与缺乏运动和使用泼尼松的影响一致。
相当一部分SLE女性患者睡眠质量差。研究结果表明，抑郁情绪、泼尼松的使用和缺乏运动导致总体睡眠质量下降。
