Background Depression is one of the most frequent disorders in SLE, from 17% to 75% of prevalence, although subtle neuropsychiatric syndromes like symptoms of depressive and anxiety axes are often considered as ‘non-neuropsychiatric SLE’. Recent data suggest SLE patients also suffer from sleep disturbances like frequent awakenings and unrestorative sleep, and worse sleep quality has been found to be a fellow traveller with this disease.
Aims to objectively evaluate sleep in SLE patients in comparison with a cohort of age and sex-matched controls and to find possible relationships with disease manifestations and to find the factors that have greater impact on mood disorders in SLE group.
Methods sleep was evaluated in 41 SLE patients and 36 controls using actigraphy. The presence of mood disorders, temperament, health-related quality of life and perception of sleep were evaluated with specific questionnaires: Beck Depression Inventory (BDI), Self Rating Anxiety Scale (SAS), Brief COPE, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), Resilience Scale for adult, Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale, Brief TEMPS-M, Lupus QoL and Short Form Health survey 36 (in SLE patients and controls respectively).
Results The strongest predictors of the SLE group were higher scores in BDI and SAS index, lower Sleep Efficiency and greater Total Sleep Time.
Statistically significant differences were found between depressed SLE patients and non-depressed SLE patients in several parameters. Lower scores in FACIT fatigue scale, burden to others, pain and body image domains and higher PSS score were found in depressed SLE patients. In SLE group, FACIT score was strongly negative correlated with BDI score and positively correlated with physical domain.
Fibromyalgic SLE patients had lower scores in pain domain when compared with non-fibromyalgic SLE patients. Instead, no difference in pain domain was found between patients with joint involvement and patients without joint involvement, addressing fibromyalgia as the factor with greater impact over pain.
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