Insomnia symptoms, perceived stress and coping strategies in patients with systemic lupus erythematosus

Lupus. 2016 Aug;25(9):988-96. doi: 10.1177/0961203316631630. Epub 2016 Feb 13.

Abstract

Objective: The aim of this study is to evaluate perceived stress and coping strategies in individuals with systemic lupus erythematosus (SLE) according to the presence of insomnia symptoms, using a set of variables that include anxiety and depressive symptoms evaluation.

Methods: Ninety SLE women were evaluated in a cross-sectional study using the Perceived Stress Scale (PSS), Brief COPE, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Beck Depression Inventory (BDI) and Self-rating Anxiety Scale (SAS).

Results: Individuals with insomnia symptoms (n = 57, 66%) presented higher PSS (p < 0.001), PSQI (p < 0.0001), BDI, (p < 0.0001) scores and showed less-effective coping strategies such as the use of behavioral disengagement (p = 0.04), self-blame (p = 0.02) and emotional-focused coping (p = 0.001). In a multi-regression model ISI was the independent determinant of high PSS and of behavioral disengagement; PSQI was the only determinant of self-blame (p = 0.02) and emotional-focused coping.

Conclusions: SLE individuals with insomnia symptoms show high levels of perceived stress and more frequent use of disengaging and emotional-focused coping strategies. This body of evidence suggests that individuals with SLE and comorbid insomnia symptoms may therefore require additional interventions for insomnia.

Keywords: Neuropsychiatric lupus; nephritis; systemic lupus erythematosus.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / psychology*
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Sleep Initiation and Maintenance Disorders / complications
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Stress, Psychological / etiology
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires