The relationship between biologic therapy and sleep quality in primary Sjögren's patients: The association of sleep quality with depression, quality of life, and disease activity

Aim: Sjögren's syndrome is a chronic autoimmune disease with exocrine gland involvement. In this study, we aimed to evaluate the relationship between the use of biological agents and sleep quality in patients with primary Sjögren's syndrome and to investigate the relationship of sleep quality with multidimensional clinical parameters such as disease activity, depression and quality of life. Method: The study included 84 patients with primary Sjögren's disease who had previously applied to the outpatient clinic of Dicle University Faculty of Medicine, Department of Physical Medicine and Rehabilitation and who came back for control between 01/12/2024 and 31/05/2025, 42 of whom used biological agents and 42 of whom did not use biological agents. Firstly, demographic information of the patients was recorded. Sleep quality (PDQI), anxiety-depression (HADS), disease activity (ESSPRI) and quality of life (SF-36) scales were evaluated. Results: In the study, ANA positivity was significantly lower in patients with primary Sjögren's disease receiving biological therapy (p=0.046), while the duration of diagnosis was longer (p=0.043). Sleep quality was significantly worse in women than in men (p=0.004). PDQI scores were higher in patients with tender/swollen joints (p=0.012). Sleep quality was better in patients taking abatacept (p=0.036). PSQI scores correlated positively with ESSPRI-pain, ESSPRI-fatigue, total ESSPRI, anxiety, and depression, and negatively with quality-of-life parameters. (p<0.05). Conclusion: Our study demonstrated the effects of biological therapy on sleep quality and related parameters in patients with primary Sjögren's disease. Our findings show that sleep disturbances are more common, especially in female patients and those with sensitive joints. The fact that abatacept use is associated with improvement in sleep quality indicates the potential benefits of this therapy. Furthermore, sleep disturbances were found to be strongly associated with pain, fatigue, depression and quality of life. In line with these results, it is recommended that sleep quality should be routinely assessed in patients with Sjögren's disease and biological treatment options should be planned considering these parameters.