Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
Rheumatol Int. 2023 Jan;43(1):1-19. doi: 10.1007/s00296-022-05218-w. Epub 2022 Oct 4.
Behçet's Disease (BD) can be correlated with sleep impairment and fatigue, resulting in low quality of life (QoL); however, a comprehensive evaluation of this issue is still missing. We performed a systematic literature review (SLR) of existing evidence in literature regarding sleep quality in BD. Fifteen papers were included in the SLR. Two domains were mainly considered: global sleep characteristics (i) and the identification of specific sleep disorders (ii) in BD patients. From our analysis, it was found that patients affected by BD scored significantly higher Pittsburgh Sleep Quality Index (PSQI) compared to controls. Four papers out of 15 (27%) studied the relationship between sleep disturbance in BD and disease activity and with regards to disease activity measures, BD-Current Activity Form was adopted in all papers, followed by Behçet's Disease Severity (BDS) score, genital ulcer severity score and oral ulcer severity score. Poor sleep quality showed a positive correlation with active disease in 3 out of 4 studies. Six papers reported significant differences between BD patients with and without sleep disturbances regarding specific disease manifestations. Notably, arthritis and genital ulcers were found to be more severe when the PSQI score increased. Our work demonstrated lower quality of sleep in BD patients when compared to the general population, both as altered sleep parameters and higher incidence of specific sleep disorders. A global clinical patient evaluation should thereby include sleep assessment through the creation and adoption of disease-specific and accessible tests.
白塞病（BD）与睡眠障碍和疲劳有关，导致生活质量（QoL）降低；然而，对于这个问题的综合评估仍然缺失。我们对 BD 患者睡眠质量的现有文献进行了系统的文献回顾（SLR）。SLR 共纳入了 15 篇论文。主要考虑了两个领域：（i）BD 患者的整体睡眠特征和（ii）特定睡眠障碍的识别。我们的分析发现，与对照组相比，BD 患者的匹兹堡睡眠质量指数（PSQI）评分显著更高。15 篇论文中有 4 篇（27%）研究了 BD 中的睡眠障碍与疾病活动之间的关系，并且在所有这些论文中，均采用了 BD 现患活动表（BD-Current Activity Form）来衡量疾病活动，其次是白塞病严重程度评分（BDS）、生殖器溃疡严重程度评分和口腔溃疡严重程度评分。在 4 项研究中的 3 项中，睡眠障碍与活动性疾病呈正相关。6 篇论文报告了存在睡眠障碍和无睡眠障碍的 BD 患者之间在特定疾病表现方面的显著差异。值得注意的是，当 PSQI 评分增加时，关节炎和生殖器溃疡的严重程度更高。与普通人群相比，BD 患者的睡眠质量更差，无论是在睡眠参数改变方面还是在特定睡眠障碍的发生率方面。因此，全面的临床患者评估应包括通过创建和采用特定于疾病的、便于使用的测试来进行睡眠评估。
