Sleep Quality And Its Associated Factors In Patients With Systemic Lupus Erythematosus

To assess the prevalence of poor sleep quality and identify associated factors among patients with systemic lupus erythematosus (SLE).

A cross-sectional study was conducted at Bach Mai Hospital, Vietnam, from January 2024 to December 2024. Adult SLE patients meeting the ACR/EULAR 2019 classification criteria were consecutively enrolled. Data were collected on sociodemographic, clinical, behavioral, and psychological characteristics. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), with a global score >5 indicating poor sleep. Depression and anxiety were measured using the Beck Depression Inventory-II (BDI-II) and Hamilton Anxiety Rating Scale (HAM-A), respectively. Multivariate logistic and Tobit regression analyses were performed to identify factors associated with poor sleep quality and PSQI score.

A total of 453 SLE patients participated, of whom 66.7% exhibited poor sleep quality. In multivariate regression, poor sleep quality was independently associated with older age (OR: 1.05, 95% CI: 1.02-1.07), higher disease activity (SLEDAI; OR: 1.04, 95% CI: 1.01-1.06), greater organ damage (SLICC/ACR index; OR: 1.17, 95% CI: 1.02-1.34), and higher anxiety severity (mild: OR 2.51, moderate: OR 3.53). Alcohol use (OR: 0.24, 95% CI: 0.07-0.90) and opioid use (OR: 0.08, 95% CI: 0.01-0.99) were associated with lower odds of poor sleep quality. For PSQI score, worse sleep quality was significantly associated with older age (Coef.: 0.09, 95% CI: 0.06-0.11), more frequent lupus flares (2 episodes: Coef. 1.14; ≥3 episodes: Coef. 1.76), and higher anxiety severity (mild: 1.82; moderate: 2.34; severe: 3.99).

Multidisciplinary approaches targeting psychological well-being, disease control, and healthy lifestyle behaviors are essential to improve sleep and quality of life in this population.