{"title":"Association between sleep-disordered breathing and moderate to severe depression in systemic lupus erythematosus: the TRUMP2-SLE study","authors":"Yuichi Ishikawa, Nao Oguro, Takanori Ichikawa, Dai Kishida, Natsuki Sakurai, Chiharu Hidekawa, Kenta Shidahara, Keigo Hayashi, Yoshia Miyawaki, Yasuhiro Shimojima, Ryusuke Yoshimi, Ken-ei Sada, Nobuyuki Yajima, Noriaki Kurita","doi":"10.1101/2024.08.20.24312299","DOIUrl":null,"url":null,"abstract":"Objective: Depression is the most frequent mood disorder that impairs quality of life and medication adherence in patients with systemic lupus erythematosus (SLE). Although sleep-disordered breathing (SDB) is a contributor to depression in the general population, its prevalence in SLE patients and its impact on depression are not clear. We employed a clinical epidemiologic approach to examine them in a multicenter cohort of SLE patients.\nMethods: This was a cross-sectional study of 414 Japanese adults with SLE at five university hospitals. The main exposure was high-risk SDB, assessed with the Berlin Questionnaire. The main outcome was moderate to severe depression assessed using the Patient Health Questionnaire-9. Poisson regression models were fitted with a robust error variance to estimate adjusted prevalence ratios (aPRs).\nResults: The mean age was 47.5 years and the mean body mass index (BMI) was 22.1 kg/m2. The prevalence of high-risk SDB was 15.2% (95% confidence interval [95% CI] 11.9%-19.0%). The prevalence of moderate or severe depression was 19.1% (95% CI 15.4%-23.2%). High-risk SDB was associated with a greater likelihood of moderate to severe depression (aPR 2.62, 95% CI 1.62-4.24). All the 1-, 2-, and 3-positive risk categories for SDB were associated with moderate to severe depression, in a dose-dependent manner. Conclusion: Among patients with SLE, SDB is common, and high-risk SDB is strongly associated with moderate to severe depression. The signs and symptoms of SDB should prompt a simultaneous evaluation for concomitant depression.","PeriodicalId":501212,"journal":{"name":"medRxiv - Rheumatology","volume":"34 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"medRxiv - Rheumatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1101/2024.08.20.24312299","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Depression is the most frequent mood disorder that impairs quality of life and medication adherence in patients with systemic lupus erythematosus (SLE). Although sleep-disordered breathing (SDB) is a contributor to depression in the general population, its prevalence in SLE patients and its impact on depression are not clear. We employed a clinical epidemiologic approach to examine them in a multicenter cohort of SLE patients.
Methods: This was a cross-sectional study of 414 Japanese adults with SLE at five university hospitals. The main exposure was high-risk SDB, assessed with the Berlin Questionnaire. The main outcome was moderate to severe depression assessed using the Patient Health Questionnaire-9. Poisson regression models were fitted with a robust error variance to estimate adjusted prevalence ratios (aPRs).
Results: The mean age was 47.5 years and the mean body mass index (BMI) was 22.1 kg/m2. The prevalence of high-risk SDB was 15.2% (95% confidence interval [95% CI] 11.9%-19.0%). The prevalence of moderate or severe depression was 19.1% (95% CI 15.4%-23.2%). High-risk SDB was associated with a greater likelihood of moderate to severe depression (aPR 2.62, 95% CI 1.62-4.24). All the 1-, 2-, and 3-positive risk categories for SDB were associated with moderate to severe depression, in a dose-dependent manner. Conclusion: Among patients with SLE, SDB is common, and high-risk SDB is strongly associated with moderate to severe depression. The signs and symptoms of SDB should prompt a simultaneous evaluation for concomitant depression.