AB1255 ASSESSMENT OF SLEEP DISTURBANCES IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

Abstract

BackgroundSleep problems are common among children with chronic illnesses such as Juvenile Idiopathic Arthritis (JIA), which is one of the most common rheumatic diseases in childhood. Sleep disturbances collectively refer to impairments in the ability to initiate or maintain sleep. They can be measured by parent or child self-report and by objective measures such as actigraphy and polysomnography.ObjectivesThe aim of this study was to assess sleep disorders in children with JIA.MethodsParents of children suffering from JIA (according to the International League of Associations for Rheumatology (ILAR)), followed in rheumatology department were asked to complete a specific specialized scale for children (HIBOU) [1] to screen sleep disorders. This scale assesses five aspects of sleep: irregular schedule and daytime drowsiness, insomnia, moves in sleep, nose obstruction and ultra-vigilance. Parents were asked to answer 8 questions rated from 1 to 3 according to the frequency of the problem, 1: rarely, 2: 3 to 4 times a week and 3 if 5 to 7 times a week. If the sum is ≤ 9, only sleep hygiene is recommended. If the sum is between 10 and 15 the child requires regular supervision. If the sum is between 16 and 24, the child needs to be referred to a specialist. General demographic and clinical information (family history of chronic inflammatory disease, child’s current age, diagnosis and type of JIA, duration of disease progression and activity of the disease) were also collected.ResultsTwenty-four children with a mean age of 12 years [4-16] were included in the study. The gender ratio was 1. The mean duration of the disease was 4 years with extremes from three months to thirteen years. The frequency of each JIA subset was as follows: polyarticular with rheumatoid factor (n= 2), polyarticular without rheumatoid factor (n=5), psoriatic arthritis (n= 1), enthesitis-related arthritis (n=10) and oligoarthritis (n= 6). Irregular sleep schedule and daytime drowsiness were reported at least 3 times a week by 58.3% of the children. Insomnia and inability to initiate sleep were reported in 29.3% of the children at least 3 times a week. Parents reported exaggerated moves during sleep in 50% of the cases and airway obstruction or snoring in 58.3% more than 3 times a week. Difficulties to maintain a good night of sleep more than three times a week were reported in 25% of cases. To sum up, 29.2% of the children had a score above 15 and needed to be referred to a specialist and 58.3% of them need a regular supervision of their sleep and may need to be referred to a specialist. Only three children had a score under 9 and don’t have concerning sleep disorders according to this scale.ConclusionThis study showed that sleep disorders are a common challenge in children and adolescents with JIA which could have a huge impact on their physical and psychosocial health-related quality of life. This study highlights the need for assessment of sleep disorders in JIA patients.