Clinical Rheumatology

, Volume 36, Issue 5, pp 1053–1062 | Cite as

Predictors of poor sleep quality in patients with systemic lupus erythematosus

  • M. Inoue
  • K. Shiozawa
  • R. Yoshihara
  • T. Yamane
  • Y. Shima
  • T. Hirano
  • K. Makimoto
Original Article


Sleep problems are common in patients with systemic lupus erythematosus (SLE). This study aimed to examine the following: (1) predictors of sleep quality and (2) fluctuations in sleep quality in patients with SLE. Patients with SLE were recruited from three rheumatology centers in Japan. We collected demographic and clinical data and data on sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI), the Medical Outcome Study Short Form-12, and the Lupus Patient Reported Outcome Tool (LupusPRO). Fluctuations in sleep quality were examined by administering the PSQI a second time after a 2-week interval. We used multiple linear regression analysis to predict sleep quality. Of 205 patients who completed the survey, 62.9% showed poor sleep quality. The largest fluctuation in sleep quality was for “waking in the middle of the night or early morning.” “LupusPRO pain/vitality” was a major predictor of poor sleep. The other significant predictors were mostly LupusPRO subscales and clinical variables and SF-12 subscales were mostly non-predictive. The majority of the participants had poor sleep quality. A lupus-specific QoL scale is important for understanding poor sleep quality in SLE patients. Symptom management appeared to play a key role in improving sleep quality.


Depression Health-related quality of life Pain Poor sleep quality Predictors Systemic lupus erythematosus 



We would like to thank all patients who participated in this study and the staff at the three clinics that cooperated with the data collection. We would also like to acknowledge Dr. Atsushi Kumanogoh, Dr. Yasushi Tanaka, Dr. Chihiro. Tanaka, and Dr. Noriaki Yoh for supporting this project.

Compliance with ethical standards

This study was approved by the Ethics Committee of Osaka University and the three rheumatology centers. At the initial contact with the participant, the first author provided a verbal and written explanation in order to confirm their willingness to participate. After obtaining written informed consent, the first author handed out the set of questionnaires.




This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The first author received a research assistant scholarship for this project from Osaka University.


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2017

Authors and Affiliations

  • M. Inoue
    • 1
  • K. Shiozawa
    • 2
  • R. Yoshihara
    • 2
  • T. Yamane
    • 3
  • Y. Shima
    • 4
  • T. Hirano
    • 4
  • K. Makimoto
    • 1
  1. 1.Department of Nursing, Graduate School of MedicineOsaka UniversityOsakaJapan
  2. 2.Rheumatology & Collagen Disease CenterHyogo Prefectural Kakogawa Medical CenterKakogawaJapan
  3. 3.Rheumatology CenterKakogawa City HospitalKakogawaJapan
  4. 4.Department of Allergy and Rheumatic DiseaseOsaka University Graduate School of MedicineOsakaJapan

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