Sleep quality in patients with systemic lupus erythematosus: The role of emotional health in Tunisia.

Abstract

BackgroundSleep disturbances are common among patients with systemic lupus erythematosus (SLE) and significantly impair quality of life. Despite increasing awareness, determinants of poor sleep in this population remain underexplored.ObjectivesThis study aimed to assess sleep quality in Tunisian SLE patients and identify associated clinical and psychological factors.MethodsA cross-sectional study was conducted at Rabta Hospital in Tunisia from February to May 2023, including 100 SLE patients fulfilling the 2019 EULAR/ACR classification criteria. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Depression, anxiety, fatigue, pain, and quality of life were assessed using validated Arabic versions of the Hospital Anxiety and Depression Scale, Fatigue Severity Scale, Numeric Pain Rating Scale, and Lupus QoL.ResultsPoor sleep quality (PSQI ≥6) was observed in 58% of participants. Univariate analysis revealed associations between poor sleep and older age, family history of SLE, depression, anxiety, fatigue, moderate-to-severe pain, and disease activity. However, multivariate analysis identified emotional health domain as the sole independent predictor of poor sleep (OR = 0.955; p = .03).ConclusionEmotional health emerged as a key determinant of sleep quality among SLE patients in Tunisia. These findings highlight the need for integrated psychosocial interventions to improve both sleep and overall quality of life. Future longitudinal studies are needed to confirm these associations and assess causal relationships.