Correlation of sleep quality with fatigue and disease activity among patients with primary Sjögren’s syndrome: a cross-sectional study

Dardin, Luciana Paula; Garcia, Ana Beatriz Andrêo; Gazoni, Fernanda Martins; Santos, Fânia Cristina; Mello, Marco Túlio de; Trevisani, Virgínia Fernandes Moça

doi:10.1590/1516-3180.2019.0251.r1.1912019

Cited by 10 publications

(16 citation statements)

References 35 publications

(41 reference statements)

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“…Fatigue is multidimensional and associated with neurocognitive, neuroendocrine, environmental and behavioral components (51). Additionally, many patients with pSS have poor sleep, and correlated with fatigue (52). Sleep quality and cognitive compromises being associated with fatigue, future studies could address whether such factors could be useful as surrogate markers for fatigue in pSS.…”

Section: Discussionmentioning

confidence: 99%

Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

et al. 2021

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Sjögren’s syndrome (SS) is an autoimmune disease affecting the salivary and lacrimal glands. Symptoms range from dryness to severe extra-glandular disease involving manifestations in the skin, lungs, nervous system, and kidney. Fatigue occurs in 70% of patients, characterizing primary SS (pSS) and significantly impacting the patient’s quality of life. There are some generic and specific instruments used to measure fatigue in SS. The mechanisms involved with fatigue in SS are still poorly understood, but it appears fatigue signaling pathways are more associated with cell protection and defense than with pro-inflammatory pathways. There are no established pharmacological treatment options for fatigue in pSS. So far, exercise and neuromodulation techniques have shown positive effects on fatigue in pSS. This study briefly reviews fatigue in pSS, with special attention to outcome measures, biomarkers, and possible treatment options.

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Section: Discussionmentioning

confidence: 99%

Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

et al. 2021

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“…Previous studies determined the sleep efficiency of pSS patients using actigraphy to be 86% and 89.7%, respectively. [ 32 , 33 ] Although the sleep efficiency of the pSS patients in our study was slightly higher (95.2%), polysomnography results determined the sleep efficiency of pSS patients to be 70%. [ 18 ] Further studies using alternative actigraphs, such as those that utilize small pressure sensors to detect changes in muscle tone, may provide more detailed results for pSS patients.…”

Section: Discussionmentioning

confidence: 57%

Cross-sectional assessment of sleep and fatigue in middle-aged Japanese women with primary Sjogren syndrome or rheumatoid arthritis using self-reports and wrist actigraphy

et al. 2021

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To investigate fatigue, health-related quality of life (HR-QOL), and sleep quality in women with primary Sjogren syndrome (pSS) or rheumatoid arthritis (RA) as compared with healthy controls using self-reports and wrist actigraphy. In this cross-sectional observational study, we evaluated a total of 25 patients (aged 40–75 years) with pSS, 10 with RA, and 17 healthy control subjects living in Japan. The HR-QOL was assessed using the Short Form-36. Fatigue was evaluated using the Short Form-36 vitality score, visual analog scale (VAS) for fatigue, and 2 questionnaire items using scores based on a 4-point Likert scale. Sleep quality was measured using the Japanese version of the Pittsburgh Sleep Quality Index, VAS for sleep quality, and wrist actigraphy for 14 days. Patients with pSS reported severer fatigue and lower HR-QOL than healthy controls, especially in mental health. Based on the Pittsburgh Sleep Quality Index score, 56% of the patients with pSS were poor sleepers, which was higher than healthy controls (29.4%). Furthermore, the patients with pSS scored significantly lower on the VAS for sleep quality than healthy controls (40.5 vs 63.7, P = .001). Although subjective assessments revealed slight sleep disturbances in patients with pSS, wrist actigraphy revealed no differences when compared with healthy controls for total sleep time (421.8 minutes vs 426.5 minutes), sleep efficiency (95.2% vs 96.4%), number of awakenings (1.4 vs 0.9), and wake after sleep onset (22.4 minutes vs 16.1 minutes). Poor subjective sleep quality was associated with enhanced fatigue. However, sleep efficiency, as determined by actigraphy, was not associated with fatigue. Notably, the patients with RA and healthy controls did not differ significantly in terms of fatigue or sleep quality, although patients with RA experienced more nocturnal awakenings than healthy controls (1.7 vs 0.9, P = .04). Patients with pSS experience severe fatigue, poor HR-QOL, and sleep disturbances, which are associated with fatigue. However, wrist actigraphy did not reveal differences in sleep quality, suggesting that it may not be an appropriate measure of sleep in patients with pSS.

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“…In our study, more than one third of patients presented fatigue, which is consistent with previous reports 50 . More interestingly, the fatigue level was highly correlated with excessive daytime sleepiness and insomnia, suggesting a serious impact of sleep troubles on fatigue in pSS patients 51 . Sleep disorders are increased in pSS patients 47 : reduced sleep efficiency, higher rate of awakenings, and higher rate of hypopnea have been described 52 , 53 .…”

Section: Discussionmentioning

confidence: 93%

The interplay between cognition, depression, anxiety, and sleep in primary Sjogren’s syndrome patients

Goulabchand

Castille

Navucet

et al. 2022

Sci Rep

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Primary Sjögren’s syndrome (pSS) is an autoimmune disease with frequent neurological involvement. Memory complaints are common, but their precise patterns remain unclear. We wanted to characterize patterns of neurocognitive profiles in pSS patients with cognitive complaints. Only pSS patients with memory complaints were included, prospectively. Cognitive profiles were compiled through a comprehensive cognitive evaluation by neuropsychologists. Evaluations of anxiety, depression, fatigue, sleep disorders and quality of life were performed for testing their interactions with cognitive profiles. All 32 pSS patients showed at least borderline cognitive impairment, and 17 (53%) exhibited a pathological cognitive profile: a hippocampal profile (37%), a dysexecutive profile (22%), and an instrumental profile (16%) (possible overlap). Regarding the secondary objectives: 37% of patients were depressed, and 48% exhibited a mild-to-severe anxiety trait. Sleep disorders were frequent (excessive daytime sleepiness (55%), high risk for sleep apnea (45%), and insomnia (77%)). Cognitive impairments could not be explained alone by anxiety, depression or sleep disorders. Fatigue level was strongly associated with sleep disorders. Our study highlights that cognitive complaints in pSS patients are supported by measurable cognitive impairments, apart from frequently associated disorders such as depression, anxiety or sleep troubles. Sleep disorders should be screened.

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Correlation of sleep quality with fatigue and disease activity among patients with primary Sjögren’s syndrome: a cross-sectional study

Cited by 10 publications

References 35 publications

Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

Cross-sectional assessment of sleep and fatigue in middle-aged Japanese women with primary Sjogren syndrome or rheumatoid arthritis using self-reports and wrist actigraphy

The interplay between cognition, depression, anxiety, and sleep in primary Sjogren’s syndrome patients

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