Correlation of Sleep Quality in Spondyloarthritis Patients and its Association with Disease Activitiy Parameters

Abstract

Background: Patients with chronic medical disorders are substantially more likely to have sleep related issues. Previously, various authors have reported sleep disruptions to be common in rheumatic diseases, although such sleep related issues in the spondyloarthropathies have not received much attention.. Aim: The present study was aimed to assess the effect of spondyloarthropathies on sleep quality and to see whether this effect is associated with disease activity. Material and Methods: This cross-sectional study was conducted in the rheumatology clinic, King Khalid University Hospital, during the duration of two months. A total of 85 diagnosed cases of spondyloarthritis were included. All participants were interviewed regarding their Demographic details, disease duration, medications, treatment regimens and physical examination. Sleep disturbance was measured using Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index, and the Ankylosing Spondylitis Quality of Life scale. The intensity of disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and patient’s functional status was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI). Blood inflammatory markers like ESR levels and CRP levels were also calculated for each patient. Results: Among the total 79 cases included, mean age of patients was 41.06±11.78 years, 40 (50.6%) were females, mean disease duration was 5 years. Diagnoses included Ankylosing spondylitis (48.10%), Psoriatic arthritis (43.04%), Undifferentiated spondyloarthopathy (6.33%) and IBD-related arthropathy (2.53%). Spondyloarthritis was observed to be associated with considerable impaired sleep quality on (PSQI) questionnaire. Six out of seven studied components came out to be worse and the only component which remained unaffected was “use of sleep Medication”. A significant correlation was observed between disease severity and patients ESR and CRP levels, and a significant correlation was observed between BASDAI score and all seven sleep quality parameters and overall PSQI scores. Both BASDAI score and BASFI scores correlated significantly with each other and a significant correlation was observed between the functional status (BASFI score) and Six sleep quality parameters except for use of sleep medication. Conclusion: We conclude that the sleep related problems were significantly higher in patients with spondyloarthritis and patients during active phase of disease had decreased sleep quality. Keywords: spondyloarthropathies, sleep quality, disease activity, PSQI scores.