Objectives To determine what sleep abnormalities may exist in children with juvenile rheumatoid arthritis (JRA), and their relationship to pain, dysfunction, and disease activity
Methods Case control study including 47 patients diagnosed with JIA. The diagnosis of JIA was made according to the criteria of the International League of Association of Rheumatology (ILAR), and 47 healthy children, age and sex matched. Sleep was assessed by questionnaire CSHQ (children’s sleep habits questionnaire). All parents have filled the 45 items of the CSHQ, grouped into eight subscales: (1) bedtime resistance, (2) sleep onset delay, (3) sleep duration, (4) sleep anxiety, (5) sleep-disordered breathing, (6) night Wakings, (7) parasomnias, (8) morning wakening/daytime sleepiness. The disease activity was assessed by the number of painful joints, swelling, erythrocyte sedimentation rate, and c-protein reactive. Functional assessment was based on the value of CHAQ Arabic validated. Pain was assessed by visual analog scale pain (VAS).
Results Forty-seven patients were included with 28 male (59.6%), mean age was 11.59 ± 3.35 years, with predominance of oligoarticular 12 (25.5%). Children with JIA had a total score of CSHQ significantly higher than the control cases (p = 0.001), significant differences were also found in the subscale sleep onset delay, night wakings, sleep disordered breathing and parasomnias, with a p-value respectively (0.024, 0.004, 0.004, 0.001). Significant association was found between the CSHQ total score and VAS activity physician (p = 0.016). Sleep onset delay was associated with VAS patient pain (p= 0,05), as nocturnal awakenings and VAS patient pain (p = 0.016). Finally, parasomnias and painful joints (p = 0.002); physician’s VAS activity (p = 0.015) and patient pain VAS (p = 0.03) were also correlated.
Conclusions This study suggests that sleep abnormalities are common in children with JIA. Strategies to improve sleep and reduce fatigue should be studied as a possible tool of improving the quality of life of children with rheumatic disease.
Disclosure of Interest None Declared