Background Since insomnia is a chronic problem in patients with chronic diseases, factors that are associated with it are varied.
Objectives To study the variables associated with the severity of insomnia according to the questionnaire of Oviedo's dream (QOD) in patients with spondylarthritis (AE) and psoriatic arthritis (PsA), including the activity of the disease as measured by restriction, BASDAI and DAS28.
Methods Design. Descriptive cross-sectional study. Patients: Were selected by sampling consecutive patients with AE or PsA in follow-up by our unit of biologic therapy. Inclusion criteria: adults (≥16 years old) with AE (ASAS criteria) or PsA (CASPAR criteria) capable of understanding and willing to make the questionnaires. Exclusion criteria: other rheumatic diseases, age <16 years old. Protocol: arriving at the inquiry, he was offered participate in study, explained to him and gave the patient the battery of questionnaires; your doctor performed the evaluation of activity of disease and registration of comorbidities and current medication. Main outcomes: the 3 dimensions of QOD: subjective (1) satisfaction with sleep, insomnia (2) and (3) Hypersomnia. The QOD is a semi-structured interview help diagnose insomnia and Hypersomnia according to the diagnostic criteria of CIE-10 and DSM-IV. Other variables: current medication for the AE or PsA, comorbidities, medication use for sleep and/or CPAP according to QOD, disease activity questionnaire: AE (BASDAI) and PsA (DAS28), quality of life related to health (HRQOL) by means of EQ-5 d and SF-36, perception of pain (questionnaire Brief Pain Inventory BPI), AE (BASFI, BASDAI) and PsA (DAS28, HAQ) and fatigue by FACIT. Statistical analysis: descriptive and analysis of normality. Bivariate Chi-square, T-Student, Mann-Whitney or correlations, as appropriate. Multiple=“Multiple” linear regression to 3 dependent variables (subjective satisfaction with sleep, insomnia and hypersomnia).
Results 120 patients participated: 60 patients with ad (36.7% women, 45, 1±10, 6 years) and 60 patients with APs (58.6% women, 49, 9±9, 2 years). The most common comorbidities were: anxiety, depression, and disc disease. Women had more multimorbidity (p=0, 047) and osteoporosis (p<0, 001) than men. We found no correlation between disease activity and results in QOS. Also found correlation of variables COS with an HRQOL in SF-36 with EQ-5D, or physical function. There were no differences in treatment with biological and/or DMARs. Multiple linear regression analysis showed an inverse association between subjective satisfaction with sleep and the results of the FACIT and the middle pain. Insomnia showed an association with FACIT and interference of pain with daily life. And finally, hypersomnia partnered with FACIT and middle pain.
Conclusions The insomnia and hypersomnia are 2 health problems strongly linked to pain and fatigue in patients with AE ans PsA but not with the activity of the disease. It would be necessary to work in nursing consultation the improvement in the management of sleep in these patients in a structured way to decrease the impact of insomnia and hypersomnia.
Disclosure of Interest None declared
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