Sleep and Systemic Lupus Erythematosus.

It has become increasingly evident that sleep problems are common in patients with systemic lupus erythematosus (SLE). Approximately 56-60% of patients with SLE report poor sleep quality, characterized mainly by difficulties initiating and/or maintaining sleep. Emerging data also indicate that sleep respiratory and movement disorders are prevalent in patients with SLE. Despite their prevalence and potential to negatively impact health and quality of life, sleep problems remain underrecognized, undertreated and understudied in this patient population. Only a handful of studies have been conducted to investigate determinants of sleep problems in SLE. The findings to date suggest that disease expression (activity, pain), behavioural and psychosocial factors including physical inactivity and depressed mood contribute to sleep problems in SLE. More studies, integrating a biopsychosocial approach, are needed to clarify the specific factors and underlying mechanisms that trigger and maintain sleep problems in SLE. The course of sleep problems in SLE remains unknown as studies have been cross-sectional. Directions for future research are discussed herein. Routine assessment and management of sleep problems in SLE should be part of the comprehensive care of patients with SLE. While effective pharmacological and nonpharmacological treatments are available to manage sleep problems, there are currently no studies which have specifically evaluated these strategies for patients with SLE. Given the complex interplay of factors contributing to sleep problems in SLE, a multimodal treatment approach combining several nonpharmacological strategies and possibly medication for more chronic and difficult cases, should be utilized for the management of sleep difficulties in SLE. [ABSTRACT FROM AUTHOR]