BACKGROUND: Pulse i.v. cyclophosphamide is a therapeutic option in severe forms of systemic lupus erythematosus (SLE). However, the overall toxicity and risk profile are yet to be adequately defined. OBJECTIVE: To evaluate the occurrence of sleep disturbances in SLE patients subjected to i.v. cyclophosphamide. METHODS: We studied thirty consecutive SLE patients (27 female) age range 14 to 53 years (mean 30.5 ± 10 years) that received i.v. cyclophosphamide (mg) (mean 948.27 ± 221.39). Depressive symptoms, quality of sleep, and the presence of excessive daytime sleepiness were evaluated. Disease severity was assessed by the SLEDAI. Quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI) and excessive daytime sleepiness (EDS) by the Epworth Sleepiness Scale (ESS). Depressive symptoms were evaluated using the 21-item Beck Depression Inventory (BDI). RESULTS: SLEDAI values ranged from 2 to 46 (mean 17 ± 11.4). The most common comorbidities were systemic arterial hypertension (30%), anemia (23.3%), osteoporosis (23.3%), and cardiomyopathy (6.6%). Seizures occurred in one patient (3.3%). Poor quality of sleep (PSQI e" 6) and EDS (ESS >10) were found in 66.7% and 30% of the patients, respectively. Depressive symptoms (BDI >19) were present in 40% of the patients and were associated with poor sleep quality (P = 0.03). CONCLUSIONS: Our findings show an increased prevalence of poor sleep quality and depressive symptoms in SLE patients receiving pulse i.v. cyclophosphamide. These findings were similar to other previously reported series of SLE patients regardless of the therapies used.
lupus; sleep; cyclophosphamide; SLEDAI; hypersomnolence; depression
