Objectives This study aimed to evaluate the frequency of sleep disorders in patients with rheumatoid arthritis (RA) and to explore the determinants of these disorders.
Methods It is a cross-sectional study including patients with RA. Patients with a known psychiatric disorder were excluded from the study.
The demographic characteristics of patients and the characteristics of RA were collected. Pain and fatigue were assessed by a visual analogue scale (0-100 mm), the disease activity by DAS28 - ESR (Disease Activity Score), the Functional Disability by the Arabic validated version of the Health Assessment Questionnaire (HAQ), the quality of life by Euroqol 5D and psychological state by the Arabic validated version of the questionnaire Hospital Anxiety and Depression (HAD) with its two items anxiety and depression.
Participants completed the self-rated questionnaire “Pittsburgh Sleep Quality Index (PSQI)” that assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven “component” scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The total score ranges from 0 (no disorder) and 21 (major problems) 1.
Univariate and multivariate linear regression was performed to determine factors associated with poor sleep quality.
Results 103 patients were included with a mean age of 49.7±11.4 years and a female predominance (90 (87.4%)). The median of RA duration was 8.16 years [3.25 to 14.16].
The median of global score PSQI was 5 [2-9]. Poorer Sleep quality was significantly associated with high disease activity (r =0.381, 95% CI [0.465, 1.320], p<0.001), lower quality of life (r = -0.327, 95% CI [-5.396 - 1.474], p=0.001), greater functional disability (r =0.289, 95% CI [ 0.323, 1.539], p=0.003), greater pain severity VAS (r =0.350, 95% CI [0.023, 0.075], p<0.001), increased fatigue VAS (r =0.380, 95% CI [0.030, 0.084], p<0.001), higher levels of anxiety (r =0.385, 95% CI [0.178, 0.498], p<0.001) and depression (r =0.310, 95% CI [0.103, 0.417]. In multivariate analysis, sleep disorders were associated with only higher levels of anxiety (r =0.254, 95% CI [0.033, 0.413], p=0.022).
Conclusions Our study suggests that sleep disorders, in rheumatoid arthritis, are more frequently found in patients with associated anxiety disorders.
Sleep Quality and Functional Disability in Patients with Rheumatoid Arthritis; FS Luyster, ER Chasens, MCM Wasko et al; Journal of Clinical Sleep Medicine, Vol. 7, No. 1, 2011
Disclosure of Interest None declared