Skip to main content
Top
Published in: Clinical Rheumatology 3/2021

01-03-2021 | Systemic Lupus Erythematosus | Original Article

Decreased sleep quality in patients with systemic lupus erythematosus: a meta-analysis

Authors: Li Wu, Pei-Li Shi, Sha-Sha Tao, Jin-Hui Tao, Guo-Cui Wu

Published in: Clinical Rheumatology | Issue 3/2021

Login to get access

Abstract

Objectives

To obtain a reliable estimation on the sleep quality in patients with systemic lupus erythematosus (SLE) and identify the main sleep problems, a meta-analysis was performed.

Methods

Up to March 21, 2020, PubMed, EMBASE, and Cochrane Library were searched; quality evaluation were conducted with Newcastle-Ottawa Scale; statistical analyses were performed by stata14.0 software; results were expressed by weighted mean difference or standardized mean difference (WMD/SMD) and 95% confidence interval (CI).

Results

Eighteen case-control studies were included in meta-analysis, 1086 SLE patients and 2866 controls were collected. The score of sleep quality in the case group was higher than that in the control group (SMD = 1.03, 95% CI: 0.80–1.27), and so was the Pittsburgh Sleep Quality Index (PSQI) (WMD = 3.45, 95% CI: 2.49–4.42). The first three complaints of sleep problems in PSQI were daytime dysfunction (WMD = 0.64, 95% CI: 0.36–0.92), subjective sleep quality (WMD = 0.62, 95% CI: 0.40–0.84), and habitual sleep efficiency (WMD = 0.54, 95% CI: 0.37–0.72). Subgroup analyses showed that the score of sleep quality in SLE patients were higher than controls among different regions, races, and disease duration. The sleep quality score of SLE patients with fibromyalgia (FM) was higher than that in general control, but no significant difference as compared with SLE patients without FM.

Conclusions

Our meta-analysis indicates that the sleep quality of SLE patients is worse than that of the general population; thus, more attention should be paid to the sleep status among this disease.
Key Points
The sleep quality of SLE patients is worse than that of the general population.
Region, race, and disease duration are correlated with sleep quality in SLE patients.
Appendix
Available only for authorised users
Literature
1.
go back to reference Aparicio-Soto M, Sánchez-Hidalgo M, Alarcón-de-la-Lastra C (2017) An update on diet and nutritional factors in systemic lupus erythematosus management. Nutr Res Rev 30(1):118–137CrossRef Aparicio-Soto M, Sánchez-Hidalgo M, Alarcón-de-la-Lastra C (2017) An update on diet and nutritional factors in systemic lupus erythematosus management. Nutr Res Rev 30(1):118–137CrossRef
2.
go back to reference Criswell LA, Pfeiffer KA, Lum RF, Gonzales B, Novitzke J, Kern M, Moser KL, Begovich AB, Carlton VE, Li W (2005) Analysis of families in the multiple autoimmune disease genetics consortium (MADGC) collection: the PTPN22 620W allele associates with multiple autoimmune phenotypes. Am J Hum Genet 76(4):561–571 Criswell LA, Pfeiffer KA, Lum RF, Gonzales B, Novitzke J, Kern M, Moser KL, Begovich AB, Carlton VE, Li W (2005) Analysis of families in the multiple autoimmune disease genetics consortium (MADGC) collection: the PTPN22 620W allele associates with multiple autoimmune phenotypes. Am J Hum Genet 76(4):561–571
3.
go back to reference Bahrehmand F, Vaisi-Raygani A, Kiani A, Rahimi Z, Tavilani H, Ardalan M, Vaisi-Raygani H, Shakiba E, Pourmotabbed T (2015) Matrix metalloproteinase 9 polymorphisms and systemic lupus erythematosus: correlation with systemic inflammatory markers and oxidative stress. Lupus 24(6):597–605 Bahrehmand F, Vaisi-Raygani A, Kiani A, Rahimi Z, Tavilani H, Ardalan M, Vaisi-Raygani H, Shakiba E, Pourmotabbed T (2015) Matrix metalloproteinase 9 polymorphisms and systemic lupus erythematosus: correlation with systemic inflammatory markers and oxidative stress. Lupus 24(6):597–605
4.
go back to reference Criswell L, Kariuki SN, Ghodke-Puranik Y, Dorschner JM, Chrabot BS, Kelly JA, Tsao BP, Kimberly RP, Alarcón-Riquelme ME, Jacob CO (2014) Genetic analysis of the pathogenic molecular sub-phenotype interferon-alpha identifies multiple novel loci involved in systemic lupus erythematosus Criswell L, Kariuki SN, Ghodke-Puranik Y, Dorschner JM, Chrabot BS, Kelly JA, Tsao BP, Kimberly RP, Alarcón-Riquelme ME, Jacob CO (2014) Genetic analysis of the pathogenic molecular sub-phenotype interferon-alpha identifies multiple novel loci involved in systemic lupus erythematosus
5.
go back to reference Yurkovich M, Vostretsova K, Chen W, Aviña Zubieta JA (2014) Overall and cause‐specific mortality in patients with systemic lupus erythematosus: a metaanalysis of observational studies. Arthrit Care Res 66(4):608–616 Yurkovich M, Vostretsova K, Chen W, Aviña Zubieta JA (2014) Overall and cause‐specific mortality in patients with systemic lupus erythematosus: a metaanalysis of observational studies. Arthrit Care Res 66(4):608–616
6.
go back to reference Mahieu MA, Ahn GE, Chmiel JS, Dunlop DD, Helenowski IB, Semanik P, Song J, Yount S, Chang RW, Ramsey-Goldman R (2016) Fatigue, patient reported outcomes, and objective measurement of physical activityin systemic lupus erythematosus. Lupus 25(11):1190–1199. https://doi.org/10.1177/0961203316631632 Mahieu MA, Ahn GE, Chmiel JS, Dunlop DD, Helenowski IB, Semanik P, Song J, Yount S, Chang RW, Ramsey-Goldman R (2016) Fatigue, patient reported outcomes, and objective measurement of physical activityin systemic lupus erythematosus. Lupus 25(11):1190–1199. https://​doi.​org/​10.​1177/​0961203316631632​
7.
go back to reference Hinze AM, Chu P, Sen DP, Al-Hammadi N, Ju YS, Kim AH (2019) 55 Poor sleep quality assessed subjectively associated with worsening SLE disease activity.Archives of Disease in childhood Hinze AM, Chu P, Sen DP, Al-Hammadi N, Ju YS, Kim AH (2019) 55 Poor sleep quality assessed subjectively associated with worsening SLE disease activity.Archives of Disease in childhood
9.
go back to reference Inoue M, Shiozawa K, Yoshihara R, Yamane T, Shima Y, Hirano T, Makimoto K (2017) Predictors of poor sleep quality in patients with systemic lupus erythematosus. Clin Rheumatol 36(5):1053–1062 Inoue M, Shiozawa K, Yoshihara R, Yamane T, Shima Y, Hirano T, Makimoto K (2017) Predictors of poor sleep quality in patients with systemic lupus erythematosus. Clin Rheumatol 36(5):1053–1062
10.
go back to reference Hsiao Y, Chen Y, Tseng C, Wu L, Lin W, Su VY, Perng D, Chang S, Chen Y, Chen T (2015) Sleep disorders and increased risk of autoimmune diseases in individuals without sleep apnea. Sleep 38(4):581–586 Hsiao Y, Chen Y, Tseng C, Wu L, Lin W, Su VY, Perng D, Chang S, Chen Y, Chen T (2015) Sleep disorders and increased risk of autoimmune diseases in individuals without sleep apnea. Sleep 38(4):581–586
11.
go back to reference Davies RJ, Lomer M, Yeo SI, Avloniti K, Sangle SR, D Cruz DP (2012) Weight loss and improvements in fatigue in systemic lupus erythematosus: a controlled trial of a low glycaemic index diet versus a calorie restricted diet in patients treated with corticosteroids. Lupus 21(6):649–655 Davies RJ, Lomer M, Yeo SI, Avloniti K, Sangle SR, D Cruz DP (2012) Weight loss and improvements in fatigue in systemic lupus erythematosus: a controlled trial of a low glycaemic index diet versus a calorie restricted diet in patients treated with corticosteroids. Lupus 21(6):649–655
12.
go back to reference Chu P. (Poor Sleep Quality Predicts Worsening SLE Disease Activity2018 ACR/ARHP Annual Meeting, 2018. ACR, p. Chu P. (Poor Sleep Quality Predicts Worsening SLE Disease Activity2018 ACR/ARHP Annual Meeting, 2018. ACR, p.
13.
go back to reference Tingting L, Chunying C, Yifei L, Lie W (2020) The impacts of resilience on the association between illness uncertainty and sleep quality among Chinese women with systemic lupus erythematosus. Clin Rheumatol Tingting L, Chunying C, Yifei L, Lie W (2020) The impacts of resilience on the association between illness uncertainty and sleep quality among Chinese women with systemic lupus erythematosus. Clin Rheumatol
14.
go back to reference Lillis TA, Tirone V, Gandhi N, Weinberg S, Nika A, Sequeira W, Hobfoll SE, Block JA, Jolly M (2019) Sleep Disturbance and Depression Symptoms Mediate Relationship Between Pain and Cognitive Dysfunction in Lupus. Arthritis Care Res (Hoboken) 71(3):406–412. https://doi.org/10.1002/acr.23593 Lillis TA, Tirone V, Gandhi N, Weinberg S, Nika A, Sequeira W, Hobfoll SE, Block JA, Jolly M (2019) Sleep Disturbance and Depression Symptoms Mediate Relationship Between Pain and Cognitive Dysfunction in Lupus. Arthritis Care Res (Hoboken) 71(3):406–412. https://​doi.​org/​10.​1002/​acr.​23593
15.
go back to reference Shrivastava A, Grover S, Jha S, Naidu G, Rathi M, Jain S(2019)AB0615 prevalence of depression, anxiety, fatigue and sleep disturbances in patients of RA, SLE and GPA.BMJ Publishing Group Ltd Shrivastava A, Grover S, Jha S, Naidu G, Rathi M, Jain S(2019)AB0615 prevalence of depression, anxiety, fatigue and sleep disturbances in patients of RA, SLE and GPA.BMJ Publishing Group Ltd
16.
go back to reference Iaboni A, Ibanez D, Gladman DD, Urowitz MB, Moldofsky H (2006) Fatigue in systemic lupus erythematosus: contributions of disordered sleep,sleepiness, and depression. J Rheumatol 33(12):2453–2457 Iaboni A, Ibanez D, Gladman DD, Urowitz MB, Moldofsky H (2006) Fatigue in systemic lupus erythematosus: contributions of disordered sleep,sleepiness, and depression. J Rheumatol 33(12):2453–2457
17.
go back to reference Nowicka-Sauer K, Hajduk A, Kujawska-Danecka H, Banaszkiewicz D, Smoleńska Ż, Czuszyńska Z, Siebert J (2018) Illness perception is significantly determined by depression and anxiety in systemic lupus erythematosus. Lupus 27(3):454–460. https://doi.org/10.1177/0961203317751858 Nowicka-Sauer K, Hajduk A, Kujawska-Danecka H, Banaszkiewicz D, Smoleńska Ż, Czuszyńska Z, Siebert J (2018) Illness perception is significantly determined by depression and anxiety in systemic lupus erythematosus. Lupus 27(3):454–460. https://​doi.​org/​10.​1177/​0961203317751858​
19.
go back to reference Du X, Zhao Q, Zhuang Y, Chen H, Shen B (2018) Fatigue of systemic lupus erythematosus in China: contributors and effects on the quality of life. Patient Prefer Adher 12:1729 Du X, Zhao Q, Zhuang Y, Chen H, Shen B (2018) Fatigue of systemic lupus erythematosus in China: contributors and effects on the quality of life. Patient Prefer Adher 12:1729
20.
go back to reference Zhao Q, Deng N, Chen S, Cui Y, Du X, Gu Z (2018) Systemic lupus erythematosus is associated with negatively variable impacts on domains of sleep disturbances: a systematic review and meta-analysis. Psychology, health & medicine 23(6):685–697 Zhao Q, Deng N, Chen S, Cui Y, Du X, Gu Z (2018) Systemic lupus erythematosus is associated with negatively variable impacts on domains of sleep disturbances: a systematic review and meta-analysis. Psychology, health & medicine 23(6):685–697
21.
go back to reference Balderas-Diaz S, Martinez MP, Guerrero-Contreras G, Miro E, Benghazi K, Sanchez AI, Garrido JL, Prados G (2017) Using Actigraphy and mHealth Systems for an Objective Analysis of Sleep Quality on Systemic Lupus Erythematosus Patients. Methods Inf Med 56(2):171–179. https://doi.org/10.3414/ME16-02-0011 Balderas-Diaz S, Martinez MP, Guerrero-Contreras G, Miro E, Benghazi K, Sanchez AI, Garrido JL, Prados G (2017) Using Actigraphy and mHealth Systems for an Objective Analysis of Sleep Quality on Systemic Lupus Erythematosus Patients. Methods Inf Med 56(2):171–179. https://​doi.​org/​10.​3414/​ME16-02-0011
22.
go back to reference Cervilla O, Miro E, Martinez MP, Sanchez AI, Sabio JM, Prados G (2019) Sleep quality and clinical and psychological manifestations in women with mild systemic lupus erythematosus activity compared to women with fibromyalgia: A preliminary study. Mod Rheumatol:1–9. https://doi.org/10.1080/14397595.2019.1679973 Cervilla O, Miro E, Martinez MP, Sanchez AI, Sabio JM, Prados G (2019) Sleep quality and clinical and psychological manifestations in women with mild systemic lupus erythematosus activity compared to women with fibromyalgia: A preliminary study. Mod Rheumatol:1–9. https://​doi.​org/​10.​1080/​14397595.​2019.​1679973
24.
go back to reference Cheung SM, Keenan K, Senn N, Hutcheon G, Chan K, Erwig L, Schrepf A, Dospinescu P, Gray S, Waiter G, He J, Basu N (2019) Metabolic and Structural Skeletal Muscle Health in Systemic Lupus Erythematosus-Related Fatigue: A Multimodal Magnetic Resonance Imaging Study. Arthritis Care Res (Hoboken) 71(12):1640–1646. https://doi.org/10.1002/acr.23833 Cheung SM, Keenan K, Senn N, Hutcheon G, Chan K, Erwig L, Schrepf A, Dospinescu P, Gray S, Waiter G, He J, Basu N (2019) Metabolic and Structural Skeletal Muscle Health in Systemic Lupus Erythematosus-Related Fatigue: A Multimodal Magnetic Resonance Imaging Study. Arthritis Care Res (Hoboken) 71(12):1640–1646. https://​doi.​org/​10.​1002/​acr.​23833
26.
go back to reference Figueiredo-Braga M, Cornaby C, Cortez A, Bernardes M, Terroso G, Figueiredo M, Mesquita C, Costa L, Poole BD (2018) Depression and anxiety in systemic lupus erythematosus: The crosstalk between immunological, clinical, and psychosocial factors. Medicine (Baltimore) 97(28):e11376. https://doi.org/10.1097/MD.0000000000011376 Figueiredo-Braga M, Cornaby C, Cortez A, Bernardes M, Terroso G, Figueiredo M, Mesquita C, Costa L, Poole BD (2018) Depression and anxiety in systemic lupus erythematosus: The crosstalk between immunological, clinical, and psychosocial factors. Medicine (Baltimore) 97(28):e11376. https://​doi.​org/​10.​1097/​MD.​0000000000011376​
27.
go back to reference Figueiredo-Braga M, Cornaby C, Cortez A, Bernardes M, Terroso G, Figueiredo M, Mesquita CDS, Costa L, Poole BD (2018) Influence of biological therapeutics, cytokines, and disease activity on depression in rheumatoid arthritis. J Immunol Res 2018 Figueiredo-Braga M, Cornaby C, Cortez A, Bernardes M, Terroso G, Figueiredo M, Mesquita CDS, Costa L, Poole BD (2018) Influence of biological therapeutics, cytokines, and disease activity on depression in rheumatoid arthritis. J Immunol Res 2018
29.
go back to reference Kozora E, Swigris J, Zell J, Duggan EC, Strand M, Burleson A, Make B. (Associations between exercise and cognitive impairment in patients with SLE and healthy controlsAnnual Meeting of American Psychosomatic Society Presentation, 2013 Kozora E, Swigris J, Zell J, Duggan EC, Strand M, Burleson A, Make B. (Associations between exercise and cognitive impairment in patients with SLE and healthy controlsAnnual Meeting of American Psychosomatic Society Presentation, 2013
31.
go back to reference Moon SJ, Kang KY, Kwok SK, Ju JH, Hong YS, Park SH, Jeon CH, Choi ST, Song JS, Min JK (2018) Differences in quality of life determinants according to the presence of fibromyalgia in middle-aged female patients with systemic lupus erythematosus: a multicenter, cross-sectional, single-ethnicity cohort. Int J Rheum Dis 21(6):1173–1184. https://doi.org/10.1111/1756-185X.13320 Moon SJ, Kang KY, Kwok SK, Ju JH, Hong YS, Park SH, Jeon CH, Choi ST, Song JS, Min JK (2018) Differences in quality of life determinants according to the presence of fibromyalgia in middle-aged female patients with systemic lupus erythematosus: a multicenter, cross-sectional, single-ethnicity cohort. Int J Rheum Dis 21(6):1173–1184. https://​doi.​org/​10.​1111/​1756-185X.​13320
32.
go back to reference Moraleda V, Prados G, Martínez MP, Sánchez AI, Sabio JM, Miró E (2017) Sleep quality, clinical and psychological manifestations in women with systemic lupus erythematosus. Int J Rheum Dis 20(10):1541–1550 Moraleda V, Prados G, Martínez MP, Sánchez AI, Sabio JM, Miró E (2017) Sleep quality, clinical and psychological manifestations in women with systemic lupus erythematosus. Int J Rheum Dis 20(10):1541–1550
33.
go back to reference Palagini L, Tani C, Bruno RM, Gemignani A, Mauri M, Bombardieri S, Riemann D, Mosca M (2014) Poor sleep quality in systemic lupus erythematosus: does it depend on depressive symptoms? Lupus 23(13):1350–1357 Palagini L, Tani C, Bruno RM, Gemignani A, Mauri M, Bombardieri S, Riemann D, Mosca M (2014) Poor sleep quality in systemic lupus erythematosus: does it depend on depressive symptoms? Lupus 23(13):1350–1357 
34.
go back to reference Rady HM, Ghanim DH (2013) Sleep disturbance in female patients with systemic lupus erythematosus and its relation to disease parameters. The Egyptian Rheumatologist 35(3):127–132 Rady HM, Ghanim DH (2013) Sleep disturbance in female patients with systemic lupus erythematosus and its relation to disease parameters. The Egyptian Rheumatologist 35(3):127–132
35.
go back to reference Tench C, Bentley D, Vleck V, McCurdie I, White P, D'Cruz D (2002) Aerobic fitness, fatigue, and physical disability in systemic lupus erythematosus. J Rheumatol 29(3):474–481 Tench C, Bentley D, Vleck V, McCurdie I, White P, D'Cruz D (2002) Aerobic fitness, fatigue, and physical disability in systemic lupus erythematosus. J Rheumatol 29(3):474–481
36.
go back to reference van Oers ML, Bossema ER, Thoolen BJ, Hartkamp A, Dekkers JC, Godaert GL, Kruize AA, Derksen RH, Bijlsma JW, Geenen R (2010) Variability of fatigue during the day in patients with primary Sjogren's syndrome, systemic lupus erythematosus, and rheumatoid arthritis. Clin Exp Rheumatol 28(5):715–721 van Oers ML, Bossema ER, Thoolen BJ, Hartkamp A, Dekkers JC, Godaert GL, Kruize AA, Derksen RH, Bijlsma JW, Geenen R (2010) Variability of fatigue during the day in patients with primary Sjogren's syndrome, systemic lupus erythematosus, and rheumatoid arthritis. Clin Exp Rheumatol 28(5):715–721
38.
go back to reference Cheng Y, Chen W, Huang C, Tsai S (2016) Sleep patterns in women with and without systemic lupus erythematosus Journal Sleep Research. Wiley-blackwell, Hoboken, p 137 Cheng Y, Chen W, Huang C, Tsai S (2016) Sleep patterns in women with and without systemic lupus erythematosus Journal Sleep Research. Wiley-blackwell, Hoboken, p 137
39.
go back to reference N TM, Celestin D, Ndip AV, Jacques NJ (2017) Prevalence, incidence and associated mortality of cardiovascular disease in patients with chronic kidney disease in low- and middle-income countries: a protocol for a systematic review and meta-analysis. Bmj Open 7(8) N TM, Celestin D, Ndip AV, Jacques NJ (2017) Prevalence, incidence and associated mortality of cardiovascular disease in patients with chronic kidney disease in low- and middle-income countries: a protocol for a systematic review and meta-analysis. Bmj Open 7(8)
40.
go back to reference Ying L, Yongxia C (2017) Fat Mass and Obesity Associated Gene Polymorphism and the Risk of Polycystic Ovary Syndrome: A Meta-analysis. Iran J Public Health 46(1) Ying L, Yongxia C (2017) Fat Mass and Obesity Associated Gene Polymorphism and the Risk of Polycystic Ovary Syndrome: A Meta-analysis. Iran J Public Health 46(1)
41.
go back to reference Zheng W, Xiang-Yu W, Juan L, Wen-Wei Z (2018) Prognostic and Clinicopathological Significance of BAP1 Protein Expression in Different Types of Cancer-A Meta-Analysis. Genet Test Mol Bioma 22(2) Zheng W, Xiang-Yu W, Juan L, Wen-Wei Z (2018) Prognostic and Clinicopathological Significance of BAP1 Protein Expression in Different Types of Cancer-A Meta-Analysis. Genet Test Mol Bioma 22(2)
42.
go back to reference Takele WW, Muche AA, Mekonnen ZA, Ambaw YF, Wagnew F (2019) Undernutrition and its determinants among Ethiopian adolescent girls: a protocol for systematic review and meta-analysis. Bmj Open 9(5) Takele WW, Muche AA, Mekonnen ZA, Ambaw YF, Wagnew F (2019) Undernutrition and its determinants among Ethiopian adolescent girls: a protocol for systematic review and meta-analysis. Bmj Open 9(5)
43.
go back to reference Yen C, Hung M, Wong Y, Chang C, Lai C, Wu K (2019) Role of intravenous immunoglobulin therapy in the survival rate of pediatric patients with acute myocarditis: a systematic review and meta-analysis. Sci Rep-Uk 9(1) Yen C, Hung M, Wong Y, Chang C, Lai C, Wu K (2019) Role of intravenous immunoglobulin therapy in the survival rate of pediatric patients with acute myocarditis: a systematic review and meta-analysis. Sci Rep-Uk 9(1)
44.
go back to reference Vavken P, Dorotka R (2011) The prevalence and effect of publication bias in orthopaedic meta-analyses. J Orthop Sci 16(2) Vavken P, Dorotka R (2011) The prevalence and effect of publication bias in orthopaedic meta-analyses. J Orthop Sci 16(2)
45.
go back to reference Yong-Gu H, Chang-Kyo Y (2020) Effectiveness of treadmill training on gait function in children with cerebral palsy: meta-analysis. Journal of exercise rehabilitation 16(1) Yong-Gu H, Chang-Kyo Y (2020) Effectiveness of treadmill training on gait function in children with cerebral palsy: meta-analysis. Journal of exercise rehabilitation 16(1)
46.
go back to reference Rodriguez-Morales AJ, Ochoa-Orozco SA, Sánchez-Castaño DM, Corzo-Romero JD, Erazo-Landázuri JX, Lopez-Caicedo DF, Montoya-Bernal JD, Franco-Duque T, Ospina JG, Marin-Peralta M (2018) Pittsburgh Sleep Quality Index (PSQI) and Fatigue Severity Scale (FSS) assessment in patients with post-Chikungunya chronic inflammatory rheumatism: a comparative study of a 2-year follow-up cohort in La Virginia, Risaralda, Colombia. Int J Infect Dis 73:297 Rodriguez-Morales AJ, Ochoa-Orozco SA, Sánchez-Castaño DM, Corzo-Romero JD, Erazo-Landázuri JX, Lopez-Caicedo DF, Montoya-Bernal JD, Franco-Duque T, Ospina JG, Marin-Peralta M (2018) Pittsburgh Sleep Quality Index (PSQI) and Fatigue Severity Scale (FSS) assessment in patients with post-Chikungunya chronic inflammatory rheumatism: a comparative study of a 2-year follow-up cohort in La Virginia, Risaralda, Colombia. Int J Infect Dis 73:297
47.
go back to reference Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry res 28(2):193–213 Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry res 28(2):193–213
48.
go back to reference Zhang C, Zhao MQ, Liu J, Huang Q, Li P, Ni J, Liang Y, Pan HF, Ye DQ (2015) Association of lymphotoxin alpha polymorphism with systemic lupus erythematosus and rheumatoid arthritis: a meta‐analysis. Int J Rheum Dis 18(4):398–407 Zhang C, Zhao MQ, Liu J, Huang Q, Li P, Ni J, Liang Y, Pan HF, Ye DQ (2015) Association of lymphotoxin alpha polymorphism with systemic lupus erythematosus and rheumatoid arthritis: a meta‐analysis. Int J Rheum Dis 18(4):398–407
50.
go back to reference Chung WS, Lin CL, Kao CH (2016) Association of systemic lupus erythematosus and sleep disorders: a nationwide population-based cohort study. Lupus 25(4):382–388 Chung WS, Lin CL, Kao CH (2016) Association of systemic lupus erythematosus and sleep disorders: a nationwide population-based cohort study. Lupus 25(4):382–388
Metadata
Title
Decreased sleep quality in patients with systemic lupus erythematosus: a meta-analysis
Authors
Li Wu
Pei-Li Shi
Sha-Sha Tao
Jin-Hui Tao
Guo-Cui Wu
Publication date
01-03-2021
Publisher
Springer International Publishing
Published in
Clinical Rheumatology / Issue 3/2021
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-020-05300-3

Other articles of this Issue 3/2021

Clinical Rheumatology 3/2021 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine