Autoimmune Rheumatic Disease and Sleep: A Review

Shirish R. Sangle; Colin M. Tench; David P. D'Cruz


Curr Opin Pulm Med. 2015;21(6):553-556. 

In This Article

Abstract and Introduction


Purpose of review Sleep has an important role to play in the human immune system and it is critical in the restoration and maintenance of homeostasis. Sleep deprivation and disorders may have a profound impact on health, well being and the ability to resist infection. Autoimmune rheumatic diseases are multisystem disorders that involve complicated hormonal and immunological pathophysiology. Previous studies have suggested that sleep deprivation may lead to immunological disturbance in experimental mouse models.

Recent findings Sleep disorders may trigger immune system abnormalities inducing autoantibody production, possibly leading to the development of autoimmune disease such as systemic lupus erythematosus, scleroderma or rheumatoid arthritis. Indeed, in experimental models, it has been suggested that sleep deprivation may induce the onset of autoimmune disease.

Summary Chronic deprivation of sleep is common in modern society and has been seen in various autoimmune inflammatory rheumatic diseases. We have reviewed various aspects of sleep deprivation and sleep apnoea syndrome, and their effects on the immune system and their relevance to autoimmune diseases. We hope that these data will encourage greater awareness of the role that improved sleep hygiene may play in the management of these rheumatic diseases.


The autoimmune rheumatic diseases are a group of multisystem diseases characterized by immunological abnormalities. These diseases often have overlapping clinical and immunological features. Systemic lupus erythematosus (SLE) is an inflammatory multisystem disease of unknown cause with a variable course and prognosis.[1]

Systemic lupus erythematosus predominantly affects young women of child-bearing age. There is a complex genetic background, and hormonal imbalance, pregnancy, stress, environmental factors and various drugs are associated with disease onset and flares in SLE.[2,3]

Neuropsychiatric manifestations of SLE include cerebral and spinal cord involvement, peripheral nerve lesions, psychological aspects, intractable headaches and seizures. The American College of Rheumatology have defined 19 different clinical neuropsychiatric syndromes that may complicate SLE.[4] Studies suggest that up to 70% of patients with SLE may develop neuropsychiatric abnormalities, most often occurring early in the disease course. However, this includes anxiety and depression, and it is often very difficult to differentiate the non-specific psychological stresses associated with a painful, unpredictable chronic illness from those specifically caused by the disease itself.[5,6]