Objectives To study the psychological variables associated with the severity of insomnia and hypersomnia according to the Oviedo sleep questionnaire (COS) in patients with spondylarthritis (SPA) and psoriatic arthritis (PA), including the disease activity BASDAI and DAS28.
Methods Design. Cross-sectional descriptive study. Patients: Patients with consecutive SPA or PA were selected by consecutive sampling in follow-up in rheumatology units of 4 Spanish hospitals. Inclusion criteria: Adults (age ≥16 years) with SPA (ASAS criteria) or PA (CASPAR criteria) capable of understanding and willing to perform questionnaires. Exclusion criteria: other rheumatic diseases, age <16 years. Protocol: Upon arriving at the consultation, he was offered to participate in the study, he was explained and the patient was given the battery of questionnaires; His physician performed the evaluation of disease activity and recorded the comorbidities and current medication. Main outcomes: the 3 dimensions of COS: (1) Subjective satisfaction with sleep, (2) Insomnia and (3) Hyperinsomnia. The COS is a semi-structured interview to aid the diagnosis of insomnia and hypersomnia according to the diagnostic criteria ICD-10 and DSM-IV. Other variables: current medication for SPA or PA, comorbidities, use of sleeping pills and/or CPAP according to COS questionnaire (insomnia was divided into mild <15 and moderate-severe ≥15), disease activity: AD BASDAI) and APs (DAS28); Health-related quality of life (HRQL) using SF-36; Pain perception (Brief Pain Inventory BPI questionnaire), SPA (BASDAI) and PA (DAS28, BASDAI) and FACIT fatigue, TMMS emotional intelligence, Resilience with resilience questionnaire, anxiety and depression sceening using HADs.Statistical analysis: descriptive, bivariate analysis using T-Student, Mann-Whitney and χ2; Followed by binary logistic regression (BLR) (Vd: moderate/severe insomnia).
Results A total of 126 patients participated: 65 patients with SPA (33.8% women, 49.92±10.92 years) and 61 patients with PA (60.7% women, 49.4±9.5 years) with an average of 8.4±6.8 years of disease. They used biological therapy SPA 29 (23%) and PA 28 (45.9%). The most common comorbidity were in SPA and PA: disc disease 33 (50.8%) and 18 (29.5%). 16 (24.6%). Both patients with SPA and PA were dissatisfied with their sleep (3.42±1.39). We did not find correlation of the COS variables with the HRQoL, the fatigue or the pain. There were no differences in COS scale according to biological treatment and/or FAME. Logistic regression analysis demonstrated an association between insomnia and TMMS repair, resilience and anxiety in PA. Insomnia in SPA showed an association with depression and BASDAI
Conclusions Insomnia is a common health problem in these diseases. Moderate-intense insomnia in patients with SPA was associated with an increase in BASDAI and depression. Also in patients with PA, the insomnia was associated with TMMS repair, resilience and anxiety. The patient assumes the slepp dissorder as part of this chronic illness, this jutifies the good evaluations of resilience and emotional inteligence of the evaluated patients.
Disclosure of Interest None declared
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