P201 Sleep disturbance in early rheumatoid arthritis and fibromyalgia and its association with mood and quality of life

Abstract

Abstract Background/Aims Rheumatoid arthritis (RA) and fibromyalgia (FM) are common musculoskeletal conditions associated with pain, mood and sleep disturbance, functional limitations and poor health-related quality of life (QOL). Studies report sleep problems in 50-75% established RA and 70-90% FM. The aim of this study is to quantify the presence of sleep disturbance amongst patients with newly diagnosed RA or FM, to describe any association with measures of anxiety or depression, and to investigate the impact of sleep disturbance on QOL in this patient group. Methods Patients with a clinical diagnosis of early RA or FM were recruited from Rheumatology clinics over 12 months (ethics reference: IRAS Project 252762). Patients completed baseline patient reported outcome measures prior to commencing treatment: Insomnia Severity Scale (ISS), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Physical Activity Calculator (PAC) and the Short Form-36 Health Survey (SF-36). Students t-test, Mann-Whitney and Chi-squared test were used to compare normal, non-normal and binary data respectively. Regression modelling was used to investigate the association between sleep disturbance and the general health subscale of SF-36 (GHSF-36), adjusting for age, sex and rheumatic condition. Results 161 participants were recruited: 84 had a diagnosis of early RA and 77 had FM, mean age 50 (16) years, 118 (73%) females. Moderate-to-severe insomnia was present in 34/84 (41%) of early RA patients and 56/77 (72%) of FM patients. Table 1 shows further baseline characteristics according to rheumatological diagnosis. Overall, there was a significant relationship between insomnia severity and general health (r=-0.39, p < 0.001), anxiety (r = 0.49, p < 0.001) and depression (r = 0.64, p < 0.001). Regression analysis confirmed an association between baseline sleep disturbance and general health after adjusting for age, sex and diagnosis (ß=-0.79, 95% CI -1.22 to -0.36, p < 0.001). Conclusion Although there is greater sleep and mood disturbance in patients with FM, 41% of patients with early RA also reported moderate-to-severe insomnia at the time of diagnosis. Activity levels remain similar between the two groups and insomnia severity was significantly associated with reduced health related QOL. This highlights the importance of addressing sleep, and mood, in Rheumatology clinics to help improve health related QOL. Disclosure A.J.W. Wall: None. A. Delmestri: None. N.W.I.L. Silva: None. A. Soni: None.