Sleep quality and clinical and psychological manifestations in women with mild systemic lupus erythematosus activity compared to women with fibromyalgia: A preliminary study

Objectives: This study analyzed sleep quality in fibromyalgia (FM) and systemic lupus erythematosus (SLE) and explored its relationship with other clinical and psychological manifestations. Methods: Twenty women with FM, 19 women with SLE and 22 healthy women participated in the study. Subjective sleep quality, fatigue, pain, depression and anxiety were evaluated with self-reports, and objective sleep measures were obtained with actigraphy. Comparisons were analyzed with Chi-square, Kruskal-Wallis's H and Mann-Whitney's U tests. Relationships between measurements were analyzed with Spearman's correlation coefficients. Results: Subjective sleep quality was altered in the FM and SLE groups compared to the control group (15.53 +/- 3.27, 8.47 +/- 3.20, 4.91 +/- 2.79, p < .05, respectively). FM and SLE patients reported higher levels of pain (22.65 +/- 9.87, 10.21 +/- 9.93, 2.30 +/- 3.096, p < .05), fatigue (4.67 +/- 0.37, 3.59 +/- 3.04, 2.33 +/- 0.59, p < .05) and depressive symptoms (9.90 +/- 3.78, 4.53 +/- 3.04, 4.17 +/- 3.95, p < .05) than controls, respectively. Worse subjective quality of sleep was associated with higher pain intensity and more depressive symptoms in FM and SLE. Actigraphy measures showed that FM patients spent more time in bed than subjects in the remaining groups. Conclusion: Sleep deterioration is related to more pain and depressive symptoms in FM and SLE. Addressing sleep disturbances may improve not only sleep quality but also depressive symptoms and pain.