Objective and subjective sleep disturbances in patients with systemic lupus erythematosus

Objective. To assess objective and subjective evidence of sleep disorders in patients with systemic lupus erythematosus (SLE) and to examine correlations between parameters of lupus activity, depression, and sleep disturbances. Methods. Fourteen SLE patients and 11 normal control subjects of similar age underwent all-night polysomnography on 3 consecutive nights. The patients and controls were also evaluated for daytime sleepiness by the Multiple Sleep Latency Test and completed a sleep disorders questionnaire and the Beck Depression Inventory. Results. The polysomnographic data showed that sleep in SLE patients was characterized by respiratory and movement disorders. These intrinsic primary sleep disorders are related to the symptom of restless, poor sleep at night. Lupus patients were more sleepy during the day, and their sleepiness was related to sleep fragmentation, with more arousals and stage transitions than the control group. Disease activity was associated with decreases in sleep efficiency and delta sleep and with increases in sleep fragmentation. Depression was not correlated with the activity of the disease. Conclusion. There is an enhanced presence of sleep disorders in patients with SLE. The most frequent primary sleep disorders are respiratory and movement disorders.