La Sjogren's syndrome primary (pSS) is an autoimmune condition that causes inflammation of the exocrine glands, particularly the lacrimal and salivary glands. As a result, the production of tears and saliva is reduced, causing dry eyes and mouth in patients. However, pSS is also characterised by fatigue and sleep disturbances.
Fatigue is a serious problem experienced by approximately 70% of pSS patients and can sometimes become disabling and have a major impact on quality of life.
Several studies have shown high levels of fatigue in patients with pSS, particularly at the physical level. In fact, physical fatigue seems to affect 96% of patients, and mental fatigue about 48%. Data that are certainly not to be underestimated. But what is the impact of tiredness on the eyes in patients with Sjogren's syndrome?
Not only physical fatigue in Sjogren's syndrome
A recent studio analysed the physical and mental components of fatigue related to Sjogren's syndrome, also focusing on eye fatigue which, in this disease, can be exacerbated by the presence of symptoms affecting the eyes, including irritation, dryness and eye pain. Indeed, eye fatigue can have a certain impact on daily life, affecting everyday activities. In addition, eye fatigue can also affect the quality of sleep at night.
Also not to be underestimated is the fact that many patients analysed in the study associated fatigue with a certain emotional and psychological impact, with the appearance of symptoms of anxiety and depression.
Participants also described that the experience of physical and mental fatigue can lead to the need to sleep for long periods of time. Conversely, some patients experience sleep disturbances due to severe eye irritation.
Eye fatigue and fatigue related eye disorders
Many of the patients with Sjogren's syndrome included in the study associated dry eyes with a range of other symptoms affecting the eyes, including:
- tiredness and eye fatigue
- blurred vision
- grainy feeling
- soreness
- itching
- difficulty keeping eyes open
Eye fatigue, in the most severe cases, can make it impossible to perform any daily activities. For example, in some cases, patients were unable to independently perform simple activities such as reading in the evening, writing, watching TV, using the computer or driving.
According to patient reports, eye fatigue was related to physical fatigue and the feeling of being exhausted at the end of the day. Ocular fatigue caused patients the need to sleep or, conversely, difficulty in getting to sleep, with an impact on general fatigue levels.
In addition, ocular fatigue sometimes seemed to correlate with the presence of other nocturnal ocular symptoms, which included pain and a grainy sensation. These symptoms arising during the night often led to the need to get up regularly during the night hours to apply soothing eye drops or artificial tears, both to cope with the immediate discomfort and to prevent a worsening the following morning, thus interrupting the sleeping hours.
Finally, eye symptoms and eye fatigue per se caused stress and feelings of anxiety and depression in some of the patients.
In conclusion, this new study has highlighted the complex nature of fatigue experienced by patients with pSS, which affects both the physical level, particularly the eye, and the emotional level.
In the future, the concepts highlighted in this research could contribute to a more robust clinical assessment of fatigue, ocular symptoms and the impact of these symptoms on everyday life.