Anxiety, positive anti-SSA/RO52 antibodies, and anti-histone antibodies are putative risk factors for sleep disorders in patients with systemic lupus erythematosus

Abstract

Abstract Sleep disorders are prevalent in patients with systemic lupus erythematosus (SLE) and result in an increased risk of chronic diseases, alter host defense and immune mechanisms, and impact the quality of life and cognitive function. Therefore, we explored the risk factors for sleep disorders in patients with SLE to aid the early screening of patients to facilitate early intervention. Patients admitted to the Department of Rheumatology and Immunology, Affiliated Hospital of Guangdong Medical University, from January 2020 to January 2022, and met the inclusion criteria, were enrolled in our study. Pittsburgh Sleep Quality Index (PSQI) scores were used to divide patients into control group (CG; PSQI ≤ 7) and sleep disorder group (SDG; PSQI > 7). A multifactorial binary logistic regression analysis model was used to analyze the risk factors, including demographic characteristics, clinical data, laboratory test results, and psychological and fatigue status. Among the enrolled 203 SLE patients (mean age, 32.2 ± 8.4 years; 11 men and 192 women), 92 cases (45.32%) had sleep disorders. The SDG had more patients living in rural areas, married, unemployed, chronic illness, arthralgia, depression, anxiety, and no fatigue (all P < 0.05); they also had a relatively low hemoglobin concentration (P = 0.005), and elevated anti-histone, anti-SSA/RO60, and anti-SSA/R052 antibodies (P < 0.05). Fatigue (hazard ratio [HR] = 0.41, P = 0.007) was a protective factor, and anxiety (HR = 14.86, P = 0.001), positive anti-SSA/RO52 antibody (HR = 2.71, P = 0.002), and anti-histone antibody (HR = 2.24, P = 0.023) were independent risk factors. Collectively, we concluded that anxiety and positive anti-SSA/RO52 and anti-histone antibodies are independent risk factors for sleep disorders in patients with SLE.