Unit of Allergy, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, via Alvaro del Portillo 21, 00128, Rome, Italy.
Unit of Geriatrics, Department of Medicine, Campus Bio-Medico of Rome University, Rome, Italy.
Clin Rheumatol. 2019 Jun;38(6):1561-1570. doi: 10.1007/s10067-018-04410-3. Epub 2019 Jan 28.
To investigate how the different components of sleep dysfunction described in SLE patients combine together in sleep clusters.
We conducted a cross-sectional study on a perspective cohort of 79 SLE patients (mean age 8.2 ± 14.3 years). Sleep was evaluated using Pittsburgh Sleep Quality Index (PSQI). Clusters were defined using the single components of PSQI in a hierarchical clustering model. We used Beck Depression Inventory, Hamilton Anxiety Rating Scale, and Medical Outcomes Study Short Form 36 (SF36) to measure depressive symptoms, anxiety, and quality of life, respectively.
Three sleep clusters were identified. The cluster 1 (N = 47) is characterized by the lowest values of PSQI total score. The cluster 2 (N = 21) presents higher values of sleep latency, but sleep duration similar to cluster 1. In cluster 3 (N = 11), we found sleep latency increased as in cluster 2, but the highest values of PSQI total score and reduced sleep duration. Scores of anxiety and sedentary time were higher in clusters 2 and 3 than in cluster 1. Cluster 3 presented the highest scores of depression and reduced mental and physical components of SF36.
The combination of different sleep components in SLE patients allowed us to identify three patterns of dysfunction: a first cluster with better sleep latency and duration, a second with increased sleep latency but conserved duration, and a third with impairment of both latency and duration. The stratification of sleep disorders in clusters might be useful for the personalization of therapy in relation to sleep cluster membership.
探讨 SLE 患者睡眠功能障碍的不同成分如何在睡眠簇中组合在一起。
我们对 79 例 SLE 患者（平均年龄 8.2±14.3 岁）进行了前瞻性队列研究。使用匹兹堡睡眠质量指数（PSQI）评估睡眠。使用 PSQI 的单个成分在分层聚类模型中定义簇。我们使用贝克抑郁量表、汉密尔顿焦虑量表和医疗结局研究 36 项简短量表（SF36）分别测量抑郁症状、焦虑和生活质量。
确定了三个睡眠簇。簇 1（N=47）的 PSQI 总分值最低。簇 2（N=21）表现为睡眠潜伏期较高，但睡眠时间与簇 1 相似。在簇 3（N=11）中，我们发现睡眠潜伏期增加，与簇 2 相似，但 PSQI 总分值最高，睡眠时间减少。焦虑和久坐时间得分在簇 2 和 3 中高于簇 1。簇 3 表现出最高的抑郁评分和 SF36 心理和生理成分得分降低。
SLE 患者不同睡眠成分的组合使我们能够识别三种功能障碍模式：第一簇睡眠潜伏期和持续时间较好，第二簇睡眠潜伏期增加但持续时间不变，第三簇潜伏期和持续时间均受损。根据睡眠簇成员对睡眠障碍进行分层可能有助于针对治疗进行个性化。
