Sleep disorders and other medical and socio-demographic factors in systemic scleroderma

Submitted: 12 December 2023
Accepted: 27 December 2023
Published: 12 February 2024
Abstract Views: 755
PDF: 482
HTML: 15
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

We aimed to investigate sleep disorders in patients with systemic scleroderma (SSc) and its relationship with socio-demographic and medical factors and to provide a suitable solution to better control the disease and improve the quality of life in these patients. This cross-sectional study evaluated SSc patients seen at a rheumatology clinic from September 1, 2022, through April 1, 2023.The patients were examined by the main investigator of the project and entered the study after taking the medical history and meeting the criteria of ACR 2013 Classification Criteria. Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and STOP-Bang Questionnaire were employed to investigate sleep disorders. A total of 103 patients were included in the study. The average age of the patients was 48.42 ± 12.4 years. PSQI showed lower quality of sleep scores among SSc (68% of patients), which was significantly related to the degree of skin stiffness in patients, telangiectasia, interstitial lung disease (ILD) in computed tomography (CT) scan, patient age, duration of the disease, and pulmonary artery pressure (PAP). STOP-Bang Questionnaire revealed that obstructive sleep apnea (OSA) was significantly associated with telangiectasia, ILD, patient age, disease onset age, disease duration, body mass index and PAP. Insomnia had a statistically significant relationship with telangiectasia, ILD and patient age. Drowsiness during daily activities was not significantly related to any of the individual variables and disease-related variables. Sleep disorders are common in patients with systemic scleroderma. Telangiectasia, ILD and patient age were related to all sleep quality disorders and respiratory apnea and insomnia. Furthermore, the amount of skin involvement significantly causes disturbances in the quality of sleep of patients, where in the group with diffuse skin stiffness, 80% of patients exhibited disturbances in the quality of sleep. Therefore, paying attention to sleep health can be an effective factor in improving the quality of life of patients with SSc.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Gabrielli A, Avvedimento EV, Krieg T. Scleroderma. N Engl J Med. 2009 May 7;360(19):1989-2003. PMID: 19420368. DOI: https://doi.org/10.1056/NEJMra0806188
Crowell MD, Umar SB, Griffing WL, DiBaise JK, Lacy BE, Vela MF. Esophageal Motor Abnormalities in Patients With Scleroderma: Heterogeneity, Risk Factors, and Effects on Quality of Life. Clin Gastroenterol Hepatol. 2017 Feb;15(2):207-213.e1. Epub 2016 Sep 6. PMID: 27613260. DOI: https://doi.org/10.1016/j.cgh.2016.08.034
Artlett CM. The IL-1 family of cytokines. Do they have a role in scleroderma fibrosis? Immunol Lett. 2018 Mar;195:30-37. Epub 2017 Dec 5. PMID: 29203183. DOI: https://doi.org/10.1016/j.imlet.2017.11.012
Bollinger T, Bollinger A, Oster H, Solbach W. Sleep, immunity, and circadian clocks: a mechanistic model. Gerontology. 2010;56(6):574-80. Epub 2010 Feb 3. PMID: 20130392. DOI: https://doi.org/10.1159/000281827
Nokes BT, Raza HA, Cartin-Ceba R, Lyng PJ, Krahn LE, Wesselius L, Jokerst CE, Umar SB, Griffing WL, Neville MR, Malhotra A, Parish JM. Individuals With Scleroderma May Have Increased Risk of Sleep-Disordered Breathing. J Clin Sleep Med. 2019 Nov 15;15(11):1665-1669. PMID: 31739857; PMCID: PMC6853384. DOI: https://doi.org/10.5664/jcsm.8036
Denton CP, Khanna D. Systemic sclerosis. Lancet. 2017 Oct 7;390(10103):1685-1699. Epub 2017 Apr 13. PMID: 28413064. DOI: https://doi.org/10.1016/S0140-6736(17)30933-9
Milette K, Razykov I, Pope J, Hudson M, Motivala SJ, Baron M, Thombs BD. Clinical correlates of sleep problems in systemic sclerosis: the prominent role of pain. Rheumatology (Oxford). 2011 May;50(5):921-5. Epub 2010 Dec 17. PMID: 21169344. DOI: https://doi.org/10.1093/rheumatology/keq411
Milette K, Hudson M, Körner A, Baron M, Thombs BD; Canadian Scleroderma Research Group. Sleep disturbances in systemic sclerosis: evidence for the role of gastrointestinal symptoms, pain and pruritus. Rheumatology (Oxford). 2013 Sep;52(9):1715-20. Epub 2013 Jun 25. PMID: 23804222. DOI: https://doi.org/10.1093/rheumatology/ket223
Frech T, Hays RD, Maranian P, Clements PJ, Furst DE, Khanna D. Prevalence and correlates of sleep disturbance in systemic sclerosis: results from the UCLA scleroderma quality of life study. Rheumatology (Oxford). 2011 Jul;50(7):1280-7. doi: 10.1093/rheumatology/ker020. Epub 2011 Feb 15. PMID: 21324979; PMCID: PMC3116211. DOI: https://doi.org/10.1093/rheumatology/ker020
Prado GF, Allen RP, Trevisani VM, Toscano VG, Earley CJ. Sleep disruption in systemic sclerosis (scleroderma) patients: clinical and polysomnographic findings. Sleep Med. 2002 Jul;3(4):341-5. PMID: 14592197. DOI: https://doi.org/10.1016/S1389-9457(02)00013-8
Reading SR, Crowson CS, Rodeheffer RJ, Fitz-Gibbon PD, Maradit-Kremers H, Gabriel SE. Do rheumatoid arthritis patients have a higher risk for sleep apnea? J Rheumatol. 2009 Sep;36(9):1869-72. Epub 2009 Jul 31. PMID: 19648298; PMCID: PMC2834190. DOI: https://doi.org/10.3899/jrheum.081335
Mermigkis C, Stagaki E, Tryfon S, Schiza S, Amfilochiou A, Polychronopoulos V, Panagou P, Galanis N, Kallianos A, Mermigkis D, Kopanakis A, Varouchakis G, Kapsimalis F, Bouros D. How common is sleep-disordered breathing in patients with idiopathic pulmonary fibrosis? Sleep Breath. 2010 Dec;14(4):387-90. Epub 2010 Mar 16. PMID: 20232261. DOI: https://doi.org/10.1007/s11325-010-0336-5
Flume PA, Ciolino J, Gray S, Lester MK. Patient-reported pain and impaired sleep quality in adult patients with cystic fibrosis. J Cyst Fibros. 2009 Sep;8(5):321-5. Epub 2009 Aug 8. PMID: 19665944. DOI: https://doi.org/10.1016/j.jcf.2009.07.004
McMillan A, Morrell MJ. Sleep disordered breathing at the extremes of age: the elderly. Breathe (Sheff). 2016 Mar;12(1):50-60. DOI: https://doi.org/10.1183/20734735.003216
Minic M, Granton JT, Ryan CM. Sleep disordered breathing in group 1 pulmonary arterial hypertension. J Clin Sleep Med. 2014 Mar 15;10(3):277-83. PMID: 24634625; PMCID: PMC3927433. DOI: https://doi.org/10.5664/jcsm.3528
Sariyildiz MA, Batmaz I, Budulgan M, Bozkurt M, Yazmalar L, Inanir A, Celepkolu T, Çevik R. Sleep quality in patients with systemic sclerosis: relationship between the clinical variables, depressive symptoms, functional status, and the quality of life. Rheumatol Int. 2013 Aug;33(8):1973-9. Epub 2013 Jan 31. PMID: 23370858. DOI: https://doi.org/10.1007/s00296-013-2680-9
Matsuura E, Ohta A, Kanegae F, Haruda Y, Ushiyama O, Koarada S, Togashi R, Tada Y, Suzuki N, Nagasawa K. Frequency and analysis of factors closely associated with the development of depressive symptoms in patients with scleroderma. J Rheumatol. 2003 Aug;30(8):1782-7. PMID: 12913935.
Matsuura E, Ohta A, Kanegae F, Haruda Y, Ushiyama O, Koarada S, Togashi R, Tada Y, Suzuki N, Nagasawa K. Frequency and analysis of factors closely associated with the development of depressive symptoms in patients with scleroderma. J Rheumatol. 2003 Aug;30(8):1782-7. PMID: 12913935.
Yakut T, Balcan B, Karakurt S, Direskeneli H, Yalcinkaya Y, Peker Y. Impact of concomitant obstructive sleep apnea on pulmonary involvement and main pulmonary artery diameter in adults with scleroderma. Sleep Breath. 2021 Mar;25(1):135-143. Epub 2020 Apr 13. PMID: 32285251; PMCID: PMC7987605. DOI: https://doi.org/10.1007/s11325-020-02059-4
Niroomanesh Sh, Mohseni M, Gholizadeh M, Shokuhi N, Saedi N. Association between sleep duration and quality with risk of gestational diabetes mellitus. Journal of Iranian Medical Council. 2020;3(1):23-28.

How to Cite

Bagheri, L., Kavosi, H., Shokouhi, N., Aghayani, S., Haghighi, K. S., & Najafizadeh, S. R. (2024). Sleep disorders and other medical and socio-demographic factors in systemic scleroderma. European Journal of Translational Myology, 34(1). https://doi.org/10.4081/ejtm.2024.12183