by Lai Thuy Duong, Nguyen Thi Phuong Thuy, Duong Minh Tam, Tran Thi Thu Ha, Pham Thi Minh Nham, Cao Thi Trinh, Nguyen Hoang Thanh

Objective: To assess the prevalence of poor sleep quality and identify associated factors among patients with systemic lupus erythematosus (SLE).
Method: A cross-sectional study was conducted at Bach Mai Hospital, Vietnam, from January 2024 to December 2024. Adult SLE patients meeting the ACR/EULAR 2019 classification criteria were consecutively enrolled. Data were collected on sociodemographic, clinical, behavioral, and psychological characteristics. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), with a global score >5 indicating poor sleep. Depression and anxiety were measured using the Beck Depression Inventory-II (BDI-II) and Hamilton Anxiety Rating Scale (HAM-A), respectively. Multivariate logistic and Tobit regression analyses were performed to identify factors associated with poor sleep quality and PSQI score.
Results: A total of 453 SLE patients participated, of whom 66.7% exhibited poor sleep quality. In multivariate regression, poor sleep quality was independently associated with older age (OR: 1.05, 95% CI: 1.02–1.07), higher disease activity (SLEDAI; OR: 1.04, 95% CI: 1.01–1.06), greater organ damage (SLICC/ACR index; OR: 1.17, 95% CI: 1.02–1.34), and higher anxiety severity (mild: OR 2.51, moderate: OR 3.53). Alcohol use (OR: 0.24, 95% CI: 0.07–0.90) and opioid use (OR: 0.08, 95% CI: 0.01–0.99) were associated with lower odds of poor sleep quality. For PSQI score, worse sleep quality was significantly associated with older age (Coef.: 0.09, 95% CI: 0.06–0.11), more frequent lupus flares (2 episodes: Coef. 1.14; ≥3 episodes: Coef. 1.76), and higher anxiety severity (mild: 1.82; moderate: 2.34; severe: 3.99).
Conclusions: Multidisciplinary approaches targeting psychological well-being, disease control, and healthy lifestyle behaviors are essential to improve sleep and quality of life in this population.

Key words: systemic lupus erythematosus, sleep quality, pittsburgh sleep quality index, anxiety, depression, Vietnam