Sleep Disturbances in Lupus: Links to Stress, Trauma, and Health Outcomes
Abstract
Rationale: Self-reports of stress and experiences of stressful or traumatic events seem to be more common among people with lupus and may affect lupus disease activity and other outcomes. Stress and trauma are closely linked to sleep problems in other settings. Many people with lupus report sleep problems, such as difficulty falling asleep, night-time awakenings, or poor quality sleep. This project will study the relationships among stress and trauma, sleep problems, and lupus disease activity, symptoms, and outcomes. We think that stress, trauma, and sleep problems may contribute to differences in lupus disease activity, symptoms, and other health outcomes. Objective: Discover how stress, trauma, and sleep problems may interact to affect lupus disease activity and symptoms. Aims: The project will examine three specific aims to address the primary objective: Aim 1: Identify the association of current levels of stress and history of stressful and traumatic events with lupus symptoms and outcomes, both concurrently and longitudinally. Aim 2: Identify associations of sleep disturbances (SDs) and changes in SDs with lupus health outcomes. Aim 3: Determine the relationship among stress/trauma, SDs, and lupus symptoms and disease activity. Focus Area: This project addresses the focus area of Understanding lupus disease heterogeneity. The study will identify the ways that stress, trauma, and sleep problems affect differences in lupus activity and symptoms. What types of patients will this research help, and how will it help them? A few studies have looked at stress and experience of traumatic events among people with lupus; these events seem to be associated with worse disease status. In addition, a very high portion of lupus patients report problems with sleep. Because experiences of stress and sleep problems are so common, most lupus patients should benefit from the results. If we find that stress, reactions to traumatic events, or sleep problems play a role in disease activity or symptoms, it will suggest new avenues of therapy. What are the clinical applications, benefits, and risks? Results from this study could suggest testing existing therapies for stress reduction or sleep problems among people with lupus to find out if disease activity or symptoms improve. Current therapies for stress and sleep problems include in-person, group, or online programs called cognitive behavioral therapy, mindfulness or meditation programs, or some types of physical activity programs. None of these have significant risks, and most have shown benefits among other types of patients. It may be necessary to develop lupus-specific programs if we find that people with lupus have special concerns that arent addressed in the standard programs. What is the projected time it may take to achieve a patient-related outcome? This project will take 3 years. If our findings suggest important relationships among stress, trauma, sleep problems, and lupus disease activity, the next step would be to test how well existing programs improve stress or sleep. This next step would likely take 3 to 5 years for formal study. However, many of these programs are available now to the general public, so patients could try them on their own. What is the likely impact of this study on the understanding, prevention, diagnosis, and/or treatment of lupus? When physicians treat lupus, they don’t usually focus on life events, nonmedical events, or treatments other than medication. This study will help us understand how life events and current lifestyle factors may affect lupus disease activity. The study may also show that non-drug treatments are important to improve the health and well-being of people with lupus.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910611
Entities
People
- Patricia Katz
Organizations
- United States Army
- University of California, San Francisco