Kasitanon N, Achsavalertsak U, Maneeton B, Wangkaew S, Puntana S, Sukitawut W, Louthrenoo W
1Division of Rheumatology, Department of Internal Medicine.
Lupus. 2013 Nov;22(13):1353-60. doi: 10.1177/0961203313507355. Epub 2013 Sep 30.
Sleep disturbance is a common problem in systemic lupus erythematosus (SLE) patients. This study was performed to determine the prevalence of sleep disturbance in SLE, the factors that might be associated with sleep disturbance, and the correlation between changes in clinical parameters and sleep quality over time. Fifty-six female SLE patients from a total of 497 SLE patients (11.3%) agreed to join the study. The demographic data were recorded at baseline and the clinical data, the Pittsburgh Sleep Quality Index (PSQI) and other standardized assessment tools, disease activity index, quality of life (QoL), damage index, depression, anxiety and fatigue score, were assessed three times: the first visit was at baseline, the second time was one month later, and the third time was three months after the baseline. Thirty-one of these 56 patients (55.36%) were found to have sleep disturbances. All were females with their mean ± SD age of 37.5 ± 12.3 years, and disease duration at study entry of 8.6 ± 7.3 years. There was no association between sleep disturbances and demographic data, disease activity, clinical symptoms, the presence of autoantibodies and current steroid use. In multiple logistic regression analyses, only moderate to severe depression was the independent determinant of sleep disturbances, p = 0.036. During the three-month observation, with the treatment, the changing of total PSQI score showed a significantly positive correlation with depression, anxiety, pain and QoL. Sleep disturbances in Thai SLE patients were not uncommon but a correctable condition. Depression was strongly associated with sleep disturbances. Awareness of underlying depression as well as sleep disturbances in SLE patients and treating them properly improve QoL in SLE.
睡眠障碍是系统性红斑狼疮（SLE）患者的常见问题。本研究旨在确定SLE患者睡眠障碍的患病率、可能与睡眠障碍相关的因素，以及临床参数变化与睡眠质量随时间的相关性。从总共497例SLE患者中选取了56例女性患者（11.3%）同意参与研究。在基线时记录人口统计学数据，并使用匹兹堡睡眠质量指数（PSQI）和其他标准化评估工具对临床数据、疾病活动指数、生活质量（QoL）、损伤指数、抑郁、焦虑和疲劳评分进行三次评估：第一次评估在基线时，第二次在一个月后，第三次在基线后三个月。这56例患者中有31例（55.36%）被发现存在睡眠障碍。所有患者均为女性，平均年龄±标准差为37.5±12.3岁，研究开始时疾病持续时间为8.6±7.3年。睡眠障碍与人口统计学数据、疾病活动、临床症状、自身抗体的存在以及当前使用的类固醇之间无关联。在多元逻辑回归分析中，只有中度至重度抑郁是睡眠障碍的独立决定因素，p = 0.036。在为期三个月的观察期间，随着治疗的进行，PSQI总分的变化与抑郁、焦虑、疼痛和QoL呈显著正相关。泰国SLE患者的睡眠障碍并不罕见，但可以纠正。抑郁与睡眠障碍密切相关。认识到SLE患者潜在的抑郁以及睡眠障碍并进行适当治疗可改善SLE患者的生活质量。
