Associated factors of health-related quality of life in Indonesian Women with Systemic Lupus Erythematosus: A cross-sectional within-cohort analysis

Abstract

Objective This study aims to determine the effects of sleep quality along with age, marital status, socioeconomic status, depression, anxiety, disease activity, pain scale, and dose of corticosteroids on quality of life in women with SLE. Methods Variables were assessed in 75 women with SLE using the Pittsburgh Sleep Quality Index (PSQI), Lupus Quality of Life (Lupus QoL), Depression, Anxiety, and Stress Scale-21 (DASS-21), and Mexican SLE Disease Activity Index (MEX-SLEDAI). Bivariate and multivariate analyses were performed to determine contributors to quality of life. Results Of 75 subjects, 35 (46.7%) patients had poor sleep quality. The mean QoL score for patients is 84.27. Poor sleepers had impaired QoL in physical health (p = 0.003), emotional health (p = 0.007), pain (p = 0.003), and planning (p = 0.006), with fatigue (p < 0.0001) as the most significantly impaired. Younger age (Mean ± SD = 81.1 ± 12.67; p = 0.014) and anxiety or depression (Mean ± SD = 56.66 ± 8.17; p = 0.006) were significantly associated with lower quality-of-life scores. The linear regression results showed an R-squared of 0.361, with anxiety (β = 21.402), sleep quality (β = 8.392), and age (β = 5.526) as the most significant variables. Marital status, socioeconomic status, disease activity, pain scale, and corticosteroid dose did not correlate with QoL. Conclusion Poor sleep quality, anxiety, and younger age were significant independent predictors of lower QoL in women with SLE, explaining 36.1% of the variance. These findings suggest that psychosocial and sleep interventions are crucial for improving well-being in this population, potentially more so than focusing solely on disease activity.