A two-phase cohort study of the sleep phenotype within primary Sjögren’s syndrome and its clinical correlates
I. Lewis1, K.L. Hackett2, W.-F. Ng3, J. Ellis4, J.L. Newton5
- Institute for Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK. firstname.lastname@example.org
- Department of Social Work, Education and Community Wellbeing, Northumbria University, and CRESTA Fatigue Clinic, Newcastle upon Tyne NHS Foundation Trust, UK.
- Musculoskeletal Research Group, Newcastle University, Musculoskeletal Day Unit, Newcastle upon Tyne NHS Foundation Trust, UK.
- Northumbria Centre for Sleep Research, Faculty of Health and Life Sciences, Northumbria University, UK.
- Institute for Cellular Medicine, Newcastle University, and Department of Social Work, Education and Community Wellbeing, Northumbria University, and CRESTA Fatigue Clinic, Newcastle upon Tyne NHS Foundation Trust, UK.
2019 Vol.37, N°3 ,Suppl.118
PI 0078, PF 0082
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PMID: 31365332 [PubMed]
Accepted : 14/01/2019
In Press: 15/07/2019
To characterise the sleep profile of patients with primary Sjögren’s syndrome (pSS) and its relationship between hyper-somnolence and other clinical parameters.
In phase one of the study, we utilised cross-sectional data on daytime hyper-somnolence from the United Kingdom Primary Sjögren’s Syndrome Registry (UKPSSR) cohort (n=857, female=92.7%). Phase two relied on clinical data from a cohort of patients (n=30) with PSS, utilising symptom assessment questionnaires and sleep diaries.
Within the UKPSSR, daytime hyper-somnolence was prevalent (ESS, 8.2±5.1) amongst pSS patients with a positive correlation between daytime hyper-somnolence and fatigue (Spearman’s rs = 0.42, p<0.0001). Amongst the clinical cohort, 100% of patients had problematic sleep. Participants with pSS awoke frequently (NWAK, 2.2±1.3), had difficulty in returning back to sleep (WASO, 59.9±50.2 min vs. normal of <30min) and a reduced sleep efficiency (SE, 65.7±18.5% vs. >85%). Fatigue (FIS, 82.4 ±33.5) and orthostatic symptoms (OGS, 6.7 ±3.7) remained high in these patients.
Sleep disturbances are a problem in pSS, comprising difficulty in maintaining sleep, frequent awakenings throughout the night and difficulties in returning back to sleep. As such, the total time in bed without sleep is much greater and sleep efficiency greatly reduced. These patients in addition have a high symptomatic burden possibly contributing to and/or contributed by poor and disordered sleep.