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Systematic review of the efficacy of commonly prescribed pharmacological treatments for primary treatment of sleep disturbance in patients with diagnosed autoimmune disease.
Sleep Medicine Reviews ( IF 11.2 ) Pub Date : 2019-11-14 , DOI: 10.1016/j.smrv.2019.101232
Amy C Reynolds 1 , Nathaniel S Marshall 2 , Catherine L Hill 3 , Robert J Adams 4
Affiliation  

Sleep disturbances are commonly reported by patients with autoimmune disease, and are negatively related to both disease activity and quality of life. Despite the potential for sleep disturbance to exacerbate inflammatory pathways, acute management of sleep disturbance with pharmacological aids is not well understood in this patient group. The objective of this review was to determine the efficacy of pharmacological treatments for sleep disturbance to improve sleep outcomes in adult patients with diagnosed autoimmune disease. Four databases and grey literature were searched for randomized controlled trials which used a pharmacological treatment specifically to treat sleep disturbance in patients with diagnosed autoimmune disease, both in hospitalized and non-hospitalized settings. A sleep outcome was required to be the primary endpoint of the study. Of the 409 studies identified, a total of six were included in the systematic review. Risk of bias across the studies was largely unclear, making an assessment challenging; meta-analysis was not undertaken due to clinical and methodological heterogeneity between studies. While there appeared to be perceived improvement in self-reported sleep quantity and quality in existing studies with pharmacological treatment, there was also evidence of placebo effect on some measures. Relatively small numbers of patients have undergone gold-standard polysomnographic (PSG) recording of sleep which limits our knowledge of objectively determined sleep quantity and quality in patients with autoimmune disease receiving pharmacological treatment for sleep disturbance. Presently there is insufficient evidence to determine whether pharmacological treatment of sleep disturbance is beneficial for improving sleep quantity and quality in this patient group beyond rheumatoid arthritis.



中文翻译:

对常规药物治疗对诊断为自身免疫性疾病的患者的睡眠障碍的主要治疗效果的系统评价。

自身免疫疾病患者通常会报告睡眠障碍,并且与疾病活动和生活质量均呈负相关。尽管潜在的睡眠障碍会加剧炎症通路,但在该患者组中尚不清楚药物治疗辅助的睡眠障碍的急性治疗方法。这篇综述的目的是确定药物治疗睡眠障碍的功效,以改善诊断为自身免疫性疾病的成年患者的睡眠结局。搜索了四个数据库和灰色文献,以寻找随机对照试验,该试验采用药物治疗专门治疗了住院和非住院诊断为自身免疫性疾病的患者的睡眠障碍。睡眠结局是该研究的主要终点。在确定的409项研究中,系统评估共纳入6项。整个研究中存在偏见的风险在很大程度上尚不清楚,这使得评估具有挑战性。由于研究之间临床和方法的异质性,未进行荟萃分析。尽管在现有的药物治疗研究中,自我报告的睡眠数量和质量似乎有所改善,但也有证据表明安慰剂对某些措施有影响。相对较少的患者经历了金标准的睡眠多导睡眠图(PSG)记录,这限制了我们对接受药物治疗以治疗睡眠障碍的自身免疫性疾病患者的客观确定的睡眠数量和质量的了解。

更新日期:2019-11-14
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