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Objectives Sleep disturbance is a frequent and underrecognized feature of systemic lupus erythematosus (SLE). The aims of this study are to assess the prevalence of poor sleep quality in SLE patients and explore its demographic, clinical, and PROs associations.Methods Cross-sectional study including adult SLE patients fulfilling the 2019 EULAR/ACR classification criteria followed in a Rheumatology outpatient clinic. Patients with pre-existing sleep disorder were excluded. Demographic and clinical data, disease activity (SLEDAI-2K, SLEDAS, PGA), damage (SLICC/ACR Damage Index), fatigue (FACIT-F), anxiety/depression (HADS-A/D), function (HAQ) and quality of life (SLEQOL) were collected. Sleep quality was evaluated through the Pittsburgh Sleep Quality Index (PSQI), with scores >5 indicating poor sleep. Data from the most recent visit (January–June 2025) were analyzed. Univariate tests (chi-square, Fisher’s exact, t-test, Mann-Whitney U) and Spearman’s correlations were used to explore associations between PSQI and other variables. Logistic regression was used to assess independent associations.Results Fifty-three SLE patients were included (female: 92.5%; mean age: 45.8 ± 13.4 years; mean disease duration: 15.7±9.3 years). Poor sleep quality was observed in 58.5% of patients (mean PSQI of 7.3±3.4). PSQI score showed strong, significant correlations with lower quality of life (r=0.651, p<0.001), greater fatigue (r=-0.533, p<0.001), higher depression (r=0.492, p<0.001), higher anxiety (r=0.414, p=0.002), and lower function (r=0.490, p<0.001). Poorer sleepers were older (p=0.017) and less frequently treated with biologic therapies (p=0.027). No correlations were observed with disease activity or damage scores. In multivariate analysis, higher depression (OR 1.4 [1.1–1.8], p=0.010) and anxiety (OR 1.5 [1.1–2.0], p=0.008) remained independently associated with poor sleep.Abstract PO:12:332 Figure 1Conclusions Poor sleep quality was highly prevalent and associated with older age and less frequent use of biologic therapies. Worse sleep was correlated with greater fatigue, higher levels of anxiety and depression, reduced physical function, and impaired quality of life. Psychological distress, particularly anxiety and depression, independently predicted poor sleep, underscoring the need to integrate mental health and behavioural assessment into SLE management to improve overall well-being.