Background Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis (1). PsA and its associated psoriatic skin lesions have been found to lower the health-related quality of life, effecting physical functioning and psychosocial well-being (2). Impairment of sleep and quality of life are important symptoms in PsA.
Objectives Assesment of sleep quality and its relation with quality of life in PsA patients.
Methods 40 patients fulfilling Caspar criteria for psoriatic arthritis were selected for this study. Patients with malignancy, fibromyalgia syndrome and other systemic inflammatory rheumatic diseases were excluded. Various clinical data including patients’ general health and pain assesment with visual analog scale (VAS), morning stiffness, duration of psoriasis and psoriatic arthritis were recorded. Sleep disturbance was evaluated with Pittsburgh Sleep Quality Index (PSQI). Quality of life was assessed with Psoriatic Arthritis Quality of Life (PSAQol) and Notthingham Health Profile (NHP). Maastricht Ankylosing Spondylitis EnthesitisScore (MASES) was used for evaluation of enthesitis.
Results 40 patients (14 men, 26 women) were recruited into this study. The mean age of patients was 46,06 years and the median disease duration was 9 months. Mean score for PSOI was 5,66±3,66. 44,8 % of patient were calssified to be poor sleepers (PSOI>5). No significant correlations could be found between PSQI and VAS for pain, VAS for general health, disaese duration, morning stiffness, PASI and MASES scores. Howewer, there was a significant correlation between PSQI scores and NHP total score (p=0,001, r=0,610) and PsAQoL score (p=0,029, r=0,477). There was a statistically significant positive correlation between PsAQoL score and VAS for pain scores (p=0,002, r=0,552); with VAS for general health scores (p=0,010, r=0,471) and with MASES (p=0,001, r=0,653). There was no significant correlation between PSAQoL and erytrhocyte sedimentation rate, PASI, duration of psoriatic arthritis, duration of psoriasis
Conclusions Sleep quality in PsA patients has good correlation with quality of life. Disease duration, severity of pain, skin leisons and entesitis did not seem to interfere with sleep quality for PsA. Treatment strategies in PsA should includes not only arhritis and skin lesions but also sleep therapies to increase the quality of life of patients.
Duffin K.C., Wong B., Horn E, J., Krueger G. G. Psoriatic arthritis is a strong predictor of sleep interference in patients with psoriasis. J Am Acad Dermatol.2009;60(4):604-608.
Kwok T. and Pope J. E., Minimally Important Difference for Patient-reported Outcomes in Psoriatic Arthritis: Health Assessment Questionnaire and Pain, Fatigue, and Global Visual Analog Scales, J Rheumatol 2010;37;1024-1028.
Disclosure of Interest None Declared
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