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Yin R, Shan J, Xu R, Huang C. Fatigue and sleep quality in Chinese adults with connective tissue disease: A cross-sectional study. Sleep Breath 2024; 28:1449-1457. [PMID: 38265629 DOI: 10.1007/s11325-024-02993-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/10/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVES This study aims to evaluate fatigue and sleep quality among adults with connective tissue disease (CTD), and the interrelationship. METHODS From April 2020 to February 2021, adult CTD patients hospitalized were invited to complete sociodemographic and disease-related data, Fatigue Severity Scale (FSS), and Pittsburgh Sleep Quality Index (PSQI), as well as laboratory detection through computer query. Statistical analysis was performed using SPSS 22.0. RESULTS A total of 363 patients with CTD were included in the study. Of which, 313 patients were accompanied by single CTD (systemic lupus erythematosus (SLE) = 109, Sjogren's syndrome (SS) = 51, rheumatoid arthritis (RA) = 44, idiopathic inflammatory myopathies (IIM) = 36, Vasculitis = 17, systemic sclerosis (SSc) = 14, other = 42, respectively), and 50 patients had CTD ≥ 2. Compared with CTD = 1, patients with CTD ≥ 2 had longer disease duration, higher erythrocyte sedimentation rate, and higher IgG level (all P < 0.05). The prevalence of poor sleep quality in 363 CTD patients was 61.2%, among which, 59.1% for CTD = 1 and 74.0% for CTD ≥ 2, with significant difference (P = 0.045). Additionally, 75.5% experienced fatigue, and 75.4% for CTD = 1, 76.0% for CTD ≥ 2 (P = 0.927). Fatigue and sleep quality interacted in CTD patients (r = 0.236, P < 0.01; χ2 = 11.302, P = 0.001). Interestingly, no significant differences were found in the prevalence of fatigue and poor sleep quality among CTD subgroups, as well as the FSS score, the seven components of sleep quality and total PSQI score (P > 0.05). CONCLUSIONS More than 3/5 CTD patients experience fatigue and poor sleep quality, and not different among CTD subgroups. Targeted interventions are needed to reduce fatigue, improve sleep quality, and ultimately improve the prognosis of patients with CTD.
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Affiliation(s)
- Rulan Yin
- Department of Nursing, The First Affiliated Hospital of Soochow University, 188Th Shizi Street, Suzhou, Jiangsu, China.
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
| | - Jun Shan
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
- Medical School of Nantong University, Nantong, China
| | - Rong Xu
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Changyin Huang
- Department of Outpatient Surgery, The First Affiliated Hospital of Soochow University, 188Th Shizi Street, Suzhou, Jiangsu, China.
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Faraguna U, Porciani C, Colitta A, Bruno S, Frumento P, Stagnaro C, Tani C, Vagelli R, Mosca M. Actigraphic and self-reported characterization of sleep in systemic lupus erythematosus patients. Rheumatology (Oxford) 2024; 63:1076-1083. [PMID: 37432350 PMCID: PMC10986802 DOI: 10.1093/rheumatology/kead344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/09/2023] [Accepted: 06/27/2023] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVES In a cross-sectional study, we explored possible differences in sleep parameters between SLE patients and age- and gender-matched healthy controls through actigraphic and self-reported measures. Furthermore, we aimed to identify possible predictors of such disturbances in the patient cohort. METHODS Participants' sociodemographic data and sleep parameters were collected. Sleep parameters were evaluated through the Pittsburgh Sleep Quality Index, the Insomnia Severity Index and 7-day actigraphic monitoring. The 10-item Perceived Stress Scale was used to investigate stress. Disease activity and daily glucocorticoid dose were assessed in SLE patients. Possible predictors of the SLE group were explored through two binomial logistic models. Within the SLE group, possible predictors of sleep parameters were tested estimating multiple linear regression models. RESULTS A total of 40 SLE patients and 33 controls were included in the study. The SLE group showed worse sleep maintenance actigraphic parameters (i.e. sleep efficiency and wake after sleep onset), higher total sleep time and higher perceived stress. Within the SLE cohort, the daily glucocorticoids dose was associated with an impairment in sleep maintenance despite no reduction in sleep duration, typical of normal sleep duration insomnia, whereas perceived stress was associated with short sleep duration insomnia. CONCLUSION Compared with healthy controls, SLE patients showed worse sleep quality and greater perceived stress severity. As glucocorticoids and perceived stress are associated with different types of insomnia in these patients, a multidimensional approach to both sleep characterization and therapy might be preferred.
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Affiliation(s)
- Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Caterina Porciani
- Department of Clinical Experimental Medicine, Clinical Immunology and Allergy Unit, University of Pisa, Pisa, Italy
| | - Alessandro Colitta
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Simone Bruno
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Chiara Stagnaro
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
| | - Chiara Tani
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
| | - Roberta Vagelli
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
| | - Marta Mosca
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
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An evaluation of sleep habits and childhood-onset systemic lupus erythematosus. Clin Rheumatol 2022; 41:2831-2837. [PMID: 35639260 DOI: 10.1007/s10067-022-06225-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease, known for its heterogeneous clinical presentation. Although it is rarer in children, a more severe clinical course can be seen than in adults. It is known that sleep has physiological and developmental importance in children, and there are many studies on sleep quality in adult SLE patients. The aims of this study are to evaluate the sleep habits of children and adolescents with SLE and to compare them with their healthy peers. METHODS The study included 48 children and adolescents with SLE and 64 healthy peers as a control group. The Children's Sleep Habits Questionnaire was used to evaluate the sleep characteristics of children. RESULTS The age and gender of the children were similar across groups. The bedtime resistance and night waking scores of SLE patients were significantly higher than those of the control group. Total sleep score was higher in patients with SLE than in the control group, but there was no significant difference (47.13±7.63 vs 44.61±8.17; p=0.051). Similarly, the rate of sleep disorders in the patient group (75%) was higher than that of the control group (61%), though the differences were not statistically significant (p = 0.156). There was no correlation between disease severity and sleep problems. CONCLUSION This research demonstrated that sleep disorders tend to increase in children and adolescents with SLE. Therefore, clinicians should pay attention to sleep disorders during the follow-up sessions of children and adolescents with SLE. Key Points • Sleep disorders tend to increase in children and adolescents with SLE. • Disease severity is not associated with sleep problems.
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Wu L, Shi PL, Tao SS, Tao JH, Wu GC. Decreased sleep quality in patients with systemic lupus erythematosus: a meta-analysis. Clin Rheumatol 2020; 40:913-922. [PMID: 32748069 DOI: 10.1007/s10067-020-05300-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To obtain a reliable estimation on the sleep quality in patients with systemic lupus erythematosus (SLE) and identify the main sleep problems, a meta-analysis was performed. METHODS Up to March 21, 2020, PubMed, EMBASE, and Cochrane Library were searched; quality evaluation were conducted with Newcastle-Ottawa Scale; statistical analyses were performed by stata14.0 software; results were expressed by weighted mean difference or standardized mean difference (WMD/SMD) and 95% confidence interval (CI). RESULTS Eighteen case-control studies were included in meta-analysis, 1086 SLE patients and 2866 controls were collected. The score of sleep quality in the case group was higher than that in the control group (SMD = 1.03, 95% CI: 0.80-1.27), and so was the Pittsburgh Sleep Quality Index (PSQI) (WMD = 3.45, 95% CI: 2.49-4.42). The first three complaints of sleep problems in PSQI were daytime dysfunction (WMD = 0.64, 95% CI: 0.36-0.92), subjective sleep quality (WMD = 0.62, 95% CI: 0.40-0.84), and habitual sleep efficiency (WMD = 0.54, 95% CI: 0.37-0.72). Subgroup analyses showed that the score of sleep quality in SLE patients were higher than controls among different regions, races, and disease duration. The sleep quality score of SLE patients with fibromyalgia (FM) was higher than that in general control, but no significant difference as compared with SLE patients without FM. CONCLUSIONS Our meta-analysis indicates that the sleep quality of SLE patients is worse than that of the general population; thus, more attention should be paid to the sleep status among this disease. Key Points •The sleep quality of SLE patients is worse than that of the general population. •Region, race, and disease duration are correlated with sleep quality in SLE patients.
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Affiliation(s)
- Li Wu
- School of Nursing, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Pei-Li Shi
- School of Nursing, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Sha-Sha Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jin-Hui Tao
- Department of Rheumatology & Immunology, Anhui Provincial Hospital, Hefei, Anhui, China
| | - Guo-Cui Wu
- School of Nursing, Anhui Medical University, Hefei, 230032, Anhui, China.
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Dantas LO, Weber S, Osani MC, Bannuru RR, McAlindon TE, Kasturi S. Mobile health technologies for the management of systemic lupus erythematosus: a systematic review. Lupus 2020; 29:144-156. [PMID: 31924145 DOI: 10.1177/0961203319897139] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We aimed to perform a standardized review of available mobile health (mHealth) applications (apps) for systemic lupus erythematosus (SLE) and to conduct a systematic review of the literature on mHealth technologies in SLE. METHODS Google Play and AppStore in the United States of America were queried and the quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). Web of Science, EMBASE, Medline, and Cochrane databases were systematically searched from inception through June 2019. RESULTS Of 324 mHealth apps found, 20 were eligible for inclusion; 10 focused on education, 7 offered tools to track patient-reported symptoms, 5 included interactive online communities, and 1 enabled emoji sharing. The reviewed apps scored poorly on the MARS quality scale with a mean score 2.3 (0.6) out of 5. Of 1147 studies identified in the literature review, 21 were eligible for inclusion; 11 studies (52.4%) focused on the development and use of mHealth for providing patient information, while only 2 (9.5%) were randomized trials of mHealth interventions. CONCLUSIONS Although there is growing interest in the development of mHealth technologies to support SLE patients, currently available tools are of poor quality and limited functionality, and the literature examining this area is sparse.
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Affiliation(s)
- L O Dantas
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
- Physical Therapy Department, Federal University of São Carlos, São Carlos, Brazil
| | - S Weber
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - M C Osani
- Center for Treatment Comparison and Integrative Analysis, Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - R R Bannuru
- Center for Treatment Comparison and Integrative Analysis, Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - T E McAlindon
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - S Kasturi
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
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Shaver JL, Iacovides S. Sleep in Women with Chronic Pain and Autoimmune Conditions: A Narrative Review. Sleep Med Clin 2018; 13:375-394. [PMID: 30098754 DOI: 10.1016/j.jsmc.2018.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic pain and sleep disturbances are intricately intertwined. This narrative review provides comments on observations related to pain, stress-immunity, and sleep. Sleep evidence is reviewed from studies of select conditions involving pain (ie, functional somatic syndromes and autoimmune) that are predominant in women. Chronic pain and poor sleep encompass persistent stress-immune activation with systemic inflammation, cellular oxidative stress, and sick behavior indicators that increase morbidity and threaten quality of life. In painful conditions, sleep impairments are nearly ubiquitous, and exaggerated combined effects should not be underestimated or ignored, nor should crucial implications for clinical practice and research.
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Affiliation(s)
- Joan L Shaver
- Biobehavioral Health Science Division, University of Arizona College of Nursing, 1305 North Martin Avenue, Tucson, AZ 85721, USA.
| | - Stella Iacovides
- Faculty of Health Sciences, Brain Function Research Group, School of Physiology, University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa
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Fardoun HM, Mashat AS. Technologies Solutions Schemes for Patients' Rehabilitation. Methodologies, Models and Algorithms. Methods Inf Med 2017; 56:83-87. [PMID: 28244544 DOI: 10.3414/me17-14-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The present editorial is part of the focus theme of Methods of Information in Medicine entitled "Technologies solutions schemes for Patients' Rehabilitation: Methodologies, Models and Algorithms". The focus theme aims to present nowadays most innovative solutions to improve patients' rehabilitation by applying and using sophisticated and pioneering Information and Communication Technologies (ICT) and human factors. METHODS The focus theme explores the different existent research works and tools used, applied and developed for incapable people in terms of rehabilitation and health care, as to look into the extent methodologies, models and algorithms by means of ICT in this process. RESULTS The focus theme lists a group of research works, which are presenting various solutions using ICT systems to improve the rehabilitation process of people with physical incapacities and to help them in carrying out their daily life.
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Affiliation(s)
- Habib M Fardoun
- Habib M. Fardoun, Information Systems Department, Faculty of Computing and Information Technology, King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia, E-mail:
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