Sleepiness or fatigue? Can we detect treatable causes of tiredness in primary Sjogren's syndrome?
Sleepiness or fatigue? Can we detect treatable causes of tiredness in primary Sjogren's syndrome?
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DOI：
10.1093/rheumatology/keq023
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发表时间：
2010-06-01
期刊：
影响因子：
5.5
通讯作者：
Theander, Elke
中科院分区：
文献类型：
--
作者：
Theander, Lisa;Strombeck, Britta;Theander, Elke
目标。[目的]了解原发性SS(PSS)患者疲劳和日间嗜睡的患病率，并分析预测睡眠干扰因素和其他潜在的疲劳和嗜睡的决定因素。对连续72例PSS患者和59例年龄匹配的健康对照进行了比较。评估工具包括疲劳量表(PROF)、视觉模拟疲劳量表、Epworth嗜睡量表(ESS)、医院焦虑和抑郁量表、不宁腿综合征(RLS)诊断标准和朗德大学睡眠问卷。此外，使用欧洲风湿病联盟SS疾病活动性指数对患者的免疫紊乱、炎症和疾病活动性指标进行分析。疲劳，尤其是躯体疲劳是PSS患者的主要问题。困倦是一个小问题。与对照组相比，患者焦虑、夜尿和夜间醒来的频率明显更高。预测PSS患者白天疲劳的因素是焦虑和夜间因疼痛而唤醒。夜间排尿频繁，但与疲劳或嗜睡无关。在单因素回归分析中，仅RLS、抑郁和干燥症状对疲劳有影响。这是第一项研究表明，不仅存在睡眠障碍，而且夜间肌肉骨骼疼痛和其他睡眠干扰因素和焦虑也显著影响疲劳。因此，针对这些方面的管理战略应包括在今后治疗PSS疲劳的试验中。
Objective. To study the prevalence of fatigue and daytime sleepiness in primary SS (pSS) and analyse predicting sleep disturbing factors and other potential determinants of fatigue and sleepiness.Method. Seventy-two consecutive pSS patients and 59 age-matched healthy controls were compared. Assessment instruments were profile of fatigue (ProF), visual analogue scale fatigue, Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, restless legs syndrome (RLS) Diagnostic Criteria and Lund University Sleep Questionnaire. In addition, markers of immune disturbance, inflammation and disease activity using the European League Against Rheumatism SS Disease Activity Index were analysed in patients.Results. Fatigue, especially somatic fatigue, is the main problem for pSS patients. Sleepiness is a minor problem. Patients had significantly more often anxiety, nocturia and woke up more frequently during the night than controls. The factors that predicted daytime fatigue in pSS patients were anxiety and nightly awakenings due to pain. Nocturia was frequent but was not associated with fatigue or sleepiness. RLS, depression and sicca symptoms contributed to fatigue in the univariate regression analysis only.Conclusions. This is the first study demonstrating not only the presence of disturbed sleep, but also that nightly musculoskeletal pain and other sleep disturbing factors and anxiety significantly influence fatigue. Management strategies aimed at these aspects should therefore be included in future trials for treatment of fatigue in pSS.