Association between sleep-disordered breathing and moderate to severe depression in systemic lupus erythematosus: the...

Depression is a common mood disorder in systemic lupus erythematosus (SLE) patients, affecting quality of life and medication adherence. Sleep-disordered breathing (SDB) is a known contributor to depression in the general population, but its prevalence and impact on depression in SLE remain unclear. This study aimed to investigate the prevalence of SDB and its association with depression.

A cross-sectional study was conducted among 414 Japanese adults with SLE from five university hospitals. The main exposure was high-risk SDB, assessed with the Berlin Questionnaire. The main outcome was moderate to severe depression evaluated using the Patient Health Questionnaire-9. Poisson regression models with robust error variance estimated adjusted prevalence ratios (aPRs).

The mean age and body mass index were 47.5 years and 22.1 kg/m2, respectively. The prevalence of high-risk SDB and moderate to severe depression were 15.2% (95% confidence interval: 11.9-19.0%) and 19.1% (95% CI: 15.4-23.2%). High-risk SDB was associated with moderate to severe depression (aPR 2.63, 95% CI 1.62-4.27), with a dose-dependent relationship according to the number of positive risk categories.

SDB is common in SLE and is associated with depression. SLE patients with SDB symptoms should undergo concurrent depression screening.