title: An investigation into the prevalence of sleep disturbances in primary Sjögren's syndrome: a systematic review of the literature.
abstract: To identify whether sleep disturbances are more prevalent in primary SS (pSS) patients compared with the general population and to recognize which specific sleep symptoms are particularly problematic in this population.
  
  
  
  Electronic searches of the literature were conducted in PubMed, Medline (Ovid), Embase (Ovid), PsychINFO (Ovid) and Web of Science and the search strategy registered a priori . Titles and abstracts were reviewed by two authors independently against a set of prespecified inclusion/exclusion criteria, reference lists were examined and a narrative synthesis of the included articles was conducted.
  
  
  
  Eight whole-text papers containing nine separate studies met the inclusion criteria and were included in the narrative analysis. Few of these studies met all of the quality assessment criteria. The studies used a range of self-reported measures and objective measures, including polysomnography. Mixed evidence was obtained for some of the individual sleep outcomes, but overall compared with controls, pSS patients reported greater subjective sleep disturbances and daytime somnolence and demonstrated more night awakenings and pre-existing obstructive sleep apnoea.
  
  
  
  A range of sleep disturbances are commonly reported in pSS patients. Further polysomnography studies are recommended to confirm the increased prevalence of night awakenings and obstructive sleep apnoea in this patient group. pSS patients with excessive daytime somnolence should be screened for co-morbid sleep disorders and treated appropriately. Interventions targeted at sleep difficulties in pSS, such as cognitive behavioural therapy for insomnia and nocturnal humidification devices, have the potential to improve quality of life in this patient group and warrant further investigation.
authors.affiliation: Musculoskeletal Research Group, Institute of Cellular Medicine & NIHR Biomedical Research Centre for Ageing and Chronic Diseases.|Newcastle upon Tyne Hospitals NHS Foundation Trust.
authors.forename: Katie L
authors.initials: KL
authors.lastname: Hackett
authors.affiliation: Institute of Health and Society, Newcastle University.
authors.forename: Zoe M
authors.initials: ZM
authors.lastname: Gotts
authors.affiliation: Northumbria Centre for Sleep Research, Faculty of Health and Life Sciences, Northumbria University.
authors.forename: Jason
authors.initials: J
authors.lastname: Ellis
authors.affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust.|Faculty of Health and Life Sciences, Northumbria University.
authors.forename: Vincent
authors.initials: V
authors.lastname: Deary
authors.affiliation: Institute of Health and Society, Newcastle University.
authors.forename: Tim
authors.initials: T
authors.lastname: Rapley
authors.affiliation: Musculoskeletal Research Group, Institute of Cellular Medicine & NIHR Biomedical Research Centre for Ageing and Chronic Diseases.|Newcastle upon Tyne Hospitals NHS Foundation Trust.
authors.forename: Wan-Fai
authors.initials: WF
authors.lastname: Ng
authors.affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust.|Institute of Cellular Medicine & NIHR Biomedical Research Centre for Ageing and Chronic Diseases, Newcastle upon Tyne.
authors.forename: Julia L
authors.initials: JL
authors.lastname: Newton
authors.affiliation: School of Health Sciences, University of East Anglia, Norwich, UK.
authors.forename: Katherine H O
authors.initials: KHO
authors.lastname: Deane
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011788:Quality of Life; D012859:Sjogren's Syndrome / Q000150:complications*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy
keywords: Sjögren’s syndrome; disability evaluation; quality of life; sleep; systematic review