SLE profoundly impacts all domains of life, with worse sleep quality reported in SLE patients by both subjective and objective measures, and objective measures like the Withings Sleep Analyzer can help provide measurable outcomes in chronic diseases.
Key Findings
Results
Poor sleep quality was significantly more prevalent in SLE patients than healthy controls by subjective assessment.
Poor sleep (PSQI > 4) was reported in 82.2% of SLE cases vs 46.7% of controls (P < 0.01).
Mean PSQI score was 7.59 (SD 3.33) in SLE cases compared to 4.52 (SD 2.90) in controls.
90 SLE cases and 90 matched healthy controls were enrolled in this prospective study.
Subjective sleep assessment utilized the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS).
Results
Objective sleep assessment confirmed substantially worse sleep quality in SLE patients compared to healthy controls.
Poor sleep (WSA score ≤ 65) was found in 77.1% of SLE patients compared with only 10% of controls (P < 0.01).
Objective assessment was performed using the Withings Sleep Analyzer (WSA) in 35 SLE cases and 50 controls.
The objective findings corroborated the subjective findings, with both measures showing significantly worse sleep in SLE patients.
Results
Higher PSQI scores (worse subjective sleep quality) were independently associated with daytime sleepiness and reduced physical quality of life.
Logistic regression showed higher PSQI scores were associated with ESS scores (P < 0.01).
Higher PSQI scores were also associated with the physical domain of WHO-QoL (P < 0.01).
ESS measures daytime sleepiness, suggesting a link between nighttime sleep disturbance and daytime functioning in SLE.
Results
Objective WSA sleep scores correlated with the physical domain of quality of life in SLE patients.
WSA scores correlated with the physical domain of WHO-QoL (P = 0.02).
This finding was consistent with the subjective PSQI association with the same WHO-QoL physical domain.
The convergence of both subjective and objective measures on the physical QoL domain suggests physical functioning is a key mediator of sleep quality in SLE.
Methods
The SLE patient cohort had moderate disease activity and long disease duration, with predominantly female patients.
Mean age of cases was 37.11 (SD 13.01) years, with 90% females.
Disease duration averaged 7.12 (SD 6.65) years.
Mean disease activity as measured by SLEDAI-2K was 4.01 (SD 3.72).
Mean cumulative damage as measured by SLICC-DI was 0.40 (SD 0.76).
Discussion
The Withings Sleep Analyzer was used as an objective, non-invasive tool for sleep assessment in a clinical SLE population.
The WSA is described as an objective measure capable of providing measurable outcomes in chronic diseases.
The authors propose WSA may have 'a possible role in research, diagnosis, monitoring and follow-up' of chronic diseases.
Objective sleep assessment was feasible in a subset of participants (35 SLE cases and 50 controls), suggesting some practical limitations in larger-scale deployment.
What This Means
This research suggests that people with systemic lupus erythematosus (SLE), an autoimmune disease, experience significantly worse sleep than healthy individuals, as confirmed by both self-reported questionnaires and an objective device placed under the mattress (the Withings Sleep Analyzer). Over 80% of SLE patients reported poor sleep quality on a standard questionnaire, compared to about 47% of healthy controls. When measured objectively, the gap was even more striking — 77% of SLE patients had poor sleep scores versus only 10% of controls. The study enrolled 90 SLE patients (90% female, average age 37) and 90 matched healthy controls.
The research also found that worse sleep in SLE patients was linked to greater daytime sleepiness and, importantly, to poorer physical functioning and quality of life. Both the questionnaire-based and device-based sleep measures pointed to physical health as a key factor connecting sleep and overall wellbeing in these patients. This suggests that sleep disturbances in SLE are not just a minor inconvenience but are meaningfully tied to how well patients can function day-to-day.
This research matters because it validates the use of an easy-to-use, consumer-grade sleep monitoring device as an objective tool for measuring sleep in people with chronic diseases like SLE. This could open doors for more rigorous tracking of sleep as a health outcome in clinical trials and routine care, without requiring expensive or burdensome sleep laboratory testing. The authors suggest such tools could play a role in diagnosing sleep problems, monitoring changes over time, and evaluating the effects of treatments in SLE and potentially other chronic conditions.
Aggarwal A, Keret S, Handa R, Upadhyaya S, Gupta S. (2026). Objective and subjective sleep assessment in systemic lupus erythematosus and association with disease characteristics and quality of life.. Rheumatology (Oxford, England). https://doi.org/10.1093/rheumatology/keag092