Sleep disordered breathing in patients with primary Sjögren’s syndrome: A group controlled study

Usmani, Zafar A; Hlavac, Michael; Rischmueller, Maureen; Heraganahally, Subash S.; Hilditch, Cassie J.; Lester, Sue; Catcheside, Peter; Antic, Nick A.; Chai-Coetzer, Ching Li; McEvoy, R. Doug

doi:10.1016/j.sleep.2012.06.010

Cited by 42 publications

(48 citation statements)

References 24 publications

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“…Sleep disturbances in PSS, anxiety, nocturia and sicca problems, were also more prevalent, but only insomnia correlated with daytime sleepiness and depression had some impact on daytime sleepiness [28]. In a study by Zafar et al, PSS patients had higher level of daytime sleepiness and twice the frequency of obstructive apnoeas and hypopneas compared with control subjects but no significant correlations were found between these parameters and sleepiness scores [29]. Walker et al [30] found that PSS patients have more severe symptoms of daytime sleepiness than patients with osteoarthritis, independent of nocturia.…”

Section: Discussionmentioning

confidence: 99%

Physical activity but not sedentary activity is reduced in primary Sjögren’s syndrome

Miller

Bowman

et al. 2016

Rheumatol Int

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The aim of the study was to evaluate the levels of physical activity in individuals with primary Sjögren’s syndrome (PSS) and its relationship to the clinical features of PSS. To this cross-sectional study, self-reported levels of physical activity from 273 PSS patients were measured using the International Physical Activity Questionnaire-short form (IPAQ-SF) and were compared with healthy controls matched for age, sex and body mass index. Fatigue and other clinical aspects of PSS including disease status, dryness, daytime sleepiness, dysautonomia, anxiety and depression were assessed using validated tools. Individuals with PSS had significantly reduced levels of physical activity [median (interquartile range, IQR) 1572 (594–3158) versus 3708 (1732–8255) metabolic equivalent of task (MET) × min/week, p < 0.001], but similar levels of sedentary activity [median (IQR) min 300 (135–375) versus 343 (223–433) (MET) × min/week, p = 0.532] compared to healthy individuals. Differences in physical activity between PSS and controls increased at moderate [median (IQR) 0 (0–480) versus 1560 (570–3900) MET × min/week, p < 0.001] and vigorous intensities [median (IQR) 0 (0–480) versus 480 (0–1920) MET × min/week, p < 0.001]. Correlation analysis revealed a significant association between physical activity and fatigue, orthostatic intolerance, depressive symptoms and quality of life. Sedentary activity did not correlate with fatigue. Stepwise linear regression analysis identified symptoms of depression and daytime sleepiness as independent predictors of levels of physical activity. Physical activity is reduced in people with PSS and is associated with symptoms of depression and daytime sleepiness. Sedentary activity is not increased in PSS. Clinical care teams should explore the clinical utility of targeting low levels of physical activity in PSS.Electronic supplementary materialThe online version of this article (doi:10.1007/s00296-016-3637-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Physical activity but not sedentary activity is reduced in primary Sjögren’s syndrome

Miller

Bowman

et al. 2016

Rheumatol Int

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“…The sample size was small (<40) for a number of studies (including Gudbjörnsson et al study 2) [13, 23, 24, 27, 28] and these studies were scored as being at high risk of bias for this question.…”

Section: Assessment Of Biasmentioning

confidence: 99%

“…Overall, three studies were deemed to be of high risk of bias (including Gudbjörnsson et al study 2) [13, 23, 24], four at medium risk of bias (including Gudbjörnsson et al study 1) [23, 27–29] and two at low risk of bias [25, 26]. …”

Section: Assessment Of Biasmentioning

confidence: 99%

An investigation into the prevalence of sleep disturbances in primary Sjögren’s syndrome: a systematic review of the literature

et al. 2016

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Objectives. To identify whether sleep disturbances are more prevalent in primary SS (pSS) patients compared with the general population and to recognize which specific sleep symptoms are particularly problematic in this population. Methods. Electronic searches of the literature were conducted in PubMed, Medline (Ovid), Embase (Ovid), PsychINFO (Ovid) and Web of Science and the search strategy registered a priori. Titles and abstracts were reviewed by two authors independently against a set of prespecified inclusion/exclusion criteria, reference lists were examined and a narrative synthesis of the included articles was conducted. Results. Eight whole-text papers containing nine separate studies met the inclusion criteria and were included in the narrative analysis. Few of these studies met all of the quality assessment criteria. The studies used a range of self-reported measures and objective measures, including polysomnography. Mixed evidence was obtained for some of the individual sleep outcomes, but overall compared with controls, pSS patients reported greater subjective sleep disturbances and daytime somnolence and demonstrated more night awakenings and pre-existing obstructive sleep apnoea. Conclusions. A range of sleep disturbances are commonly reported in pSS patients. Further polysomnography studies are recommended to confirm the increased prevalence of night awakenings and obstructive sleep apnoea in this patient group. pSS patients with excessive daytime somnolence should be screened for co-morbid sleep disorders and treated appropriately. Interventions targeted at sleep difficulties in pSS, such as cognitive behavioural therapy for insomnia and nocturnal humidification devices, have the potential to improve quality of life in this patient group and warrant further investigation.

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“…37 Results of an observational study of 28 pSS patients demonstrated that these patients had twice the frequency of apnea/hypopnea compared to non-pSS control patients, suggesting that OSA may be a useful therapeutic target to improve both pSS and quality of life in these patients. 38 Recently another important inflammatory cytokine, IL-17, was found to be associated with several autoimmune diseases, including SLE, RA, inflammatory bowel disease, and Behçet disease. 39 Systemic inflammation may be amplified by the overt production of IL-17 through the activation of autoantibody production and an enhanced immune response at inflammation sites.…”

Section: Discussionmentioning

confidence: 99%

Management and Risk Reduction of Rheumatoid Arthritis in Individuals with Obstructive Sleep Apnea: A Nationwide Population-Based Study in Taiwan

Chen

Chang

et al. 2016

Sleep

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Sleep disordered breathing in patients with primary Sjögren’s syndrome: A group controlled study

Cited by 42 publications

References 24 publications

Physical activity but not sedentary activity is reduced in primary Sjögren’s syndrome

Physical activity but not sedentary activity is reduced in primary Sjögren’s syndrome

An investigation into the prevalence of sleep disturbances in primary Sjögren’s syndrome: a systematic review of the literature

Management and Risk Reduction of Rheumatoid Arthritis in Individuals with Obstructive Sleep Apnea: A Nationwide Population-Based Study in Taiwan

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