Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, China.
School of Nursing, Nantong University, Nantong, China.
Int J Rheum Dis. 2020 Mar;23(3):367-373. doi: 10.1111/1756-185X.13678. Epub 2019 Nov 25.
Sleep disturbances are common in primary Sjögren's syndrome (pSS) patients and may lead to disease aggravation and decreased health-related quality of life (HRQoL). There are currently no known reported studies related to the prevalence, correlates, and impact of sleep disturbance in pSS patients from China. Therefore, this study aims to assess the sleep quality in Chinese pSS patients and evaluate its relationship with the disease activity, quality of life and mood disorders.
A self-report survey was administered to 221 pSS patients and 198 healthy individuals using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. Disease activity and damage were evaluated with the European League Against Rheumatism Sjögren's syndrome disease activity index (ESSDAI). Independent samples t tests, Chi-square analysis, logistic regression were used to analyze these data.
Our results found that the prevalence of poor sleep (PSQI ≥ 6) was 57.5% and the mean global score of PSQI was 6.57 (SD 3.19) in patients, which were significantly higher than the controls (32.3% and 4.93 [SD 2.86], respectively). When trying to fall asleep, patients with pSS had some sleep disturbances, reduced sleep efficiency, increased number of awakenings than controls. There were significant correlations among dryness, ocular surface disease, HRQoL, pain, disease activity, anxiety/depression and sleep quality in pSS patients. Meanwhile, logistic regression models identified depression and Short Form-36 mental composite score as predictors of poor sleep quality.
Sleep disturbances are commonly reported in pSS patients and sleep quality is lower in pSS patients than in healthy controls. The data suggested the need for holistic assessment and management of pSS patients.
原发性干燥综合征（pSS）患者常存在睡眠障碍，可能导致病情加重和健康相关生活质量（HRQoL）下降。目前尚无关于中国 pSS 患者睡眠障碍的患病率、相关性和影响的已知报告研究。因此，本研究旨在评估中国 pSS 患者的睡眠质量，并评估其与疾病活动度、生活质量和情绪障碍的关系。
采用匹兹堡睡眠质量指数（PSQI）对 221 例 pSS 患者和 198 例健康对照者进行睡眠质量的自评调查。采用欧洲抗风湿病联盟干燥综合征疾病活动指数（ESSDAI）评估疾病活动度和损害。采用独立样本 t 检验、卡方检验、Logistic 回归分析这些数据。
我们的结果发现，pSS 患者中睡眠质量差（PSQI≥6）的患病率为 57.5%，PSQI 总分平均值为 6.57（SD 3.19），明显高于对照组（分别为 32.3%和 4.93 [SD 2.86]）。在试图入睡时，pSS 患者存在一些睡眠障碍，睡眠效率降低，觉醒次数增加。干燥、眼表疾病、HRQoL、疼痛、疾病活动度、焦虑/抑郁与 pSS 患者的睡眠质量之间存在显著相关性。同时，Logistic 回归模型确定抑郁和 SF-36 心理综合评分是睡眠质量差的预测因子。
pSS 患者常报告睡眠障碍，pSS 患者的睡眠质量低于健康对照者。数据表明需要对 pSS 患者进行全面评估和管理。
