Factors associated with life quality, sleep quality, and depression in systemic sclerosis patients: a cross-sectional study from Iran.

Objective: This study aimed to determine the prevalence and associated factors of depressive symptoms, poor sleep, and life quality among patients with systemic sclerosis (SSc).

Methods: This was a cross-sectional study including 120 SSc patients. Demographic and clinical data were obtained. The Short Form Health Survey 36 (SF-36), Pittsburgh Sleep Quality Index (PSQI), and short form of the Beck Depression Questionnaire were used to evaluate life quality, sleep quality, and self-reported depressive symptoms, respectively. The obtained data were analyzed to identify the demographic and clinical risk associations for depressive symptoms, poor sleep, and life quality.

Results: Of 120 participants, 108 patients (90%) were female. The mean age was 42.23 years, and the mean disease duration was 13.58 years. Most of the patients were married, unemployed, or housekeepers. Most of them had moderate economic conditions and tertiary education. The total scores of the SF-36 and PSQI questionnaires were 93.25±3.7 and 9.02±4.51, respectively, which showed good life quality but poor sleep quality. The prevalence of depressive symptoms was 44.16% (n=53), and most of them had mild to moderate depressive symptoms. The factors that correlated with life quality were occupational status and cough. The factors that negatively correlated with sleep quality were the presence of digital ulcers, cough, and dysphasia. The presence of cough, dyspnea, and gastroesophageal reflux disease was associated with depressive symptoms.

Conclusions: Our study showed a high prevalence of poor sleep quality and depressive symptoms among SSc patients. We found that gastrointestinal symptoms, respiratory symptoms, and digital ulcers affected patients' life quality, sleep quality, and mental status. Our results also demonstrated that depression was correlated with poor sleep quality, and they were both risk factors for diminished life quality. Identification of these factors would help to make pharmacological and non-pharmacological interventions to improve the quality of life and sleep in SSc patients.