Sleep disturbances in patients with systemic lupus erythematosus: a questionnaire-based study

To assess the prevalence of subjective sleeping complaints by patients with systemic lupus erythematosus (SLE) and to evaluate the correlation between various sleeping complaints and disease activity.

A standardised sleep questionnaire, The Uppsala Sleep Inventory, was used to investigate the sleeping habits of 30 outpatients with systemic lupus erythematosus (SLE) in comparison to population-based age- and sex-matched controls.

Sleep deficit (difference between need of sleep and actual sleeping time) was similar in patients with SLE (0.8 +/- 0.9 hour) and age-matched female controls (0.4 +/- 0.8 hour). However, patients with SLE reported more frequent disturbances due to pain, both when trying to fall asleep (p < 0.01) and during the night (p < 0.01). They also reported frequent awakenings due to headache (p < 0.01) and disturbances due to other vegetative symptoms. Furthermore, the SLE patients were awake for significantly longer periods during the night and they estimated their degree of fatigue as significantly higher than the female controls (p < 0.0001).

Patients with SLE seem to get a fairly normal amount of sleep, but are frequently disturbed by pain and by various vegetative symptoms, e.g. breathlessness, sweating, and palpitation, which indicate not only pain but also possible involvement of the nervous system. The nervous system may therefore play a role in sleep disturbances reported by patients with SLE.