Sleep and its relationship to health-related quality of life in children and adolescents with inactive juvenile idiopathic arthritis

Abstract

Aim of the workTo describe and compare sleep disturbance in children and adolescents with inactive juvenile idiopathic arthritis (JIA) and to study their relation to health-related quality of life (HRQoL). Patients and methodsFifty JIA patients and 50 controls along with their parents were studied. Sleep disturbance was assessed by the Children's Sleep Habits Questionnaire (CSHQ) and HRQoL was assessed according to the revised KINDLR questionnaire. ResultsThe 50 JIA children were 14 boys (28%) and 36 girls (72%); 58% children and 42% adolescent. The mean age of participants was comparable between boys (11.6 ± 2.9 years) and girls (11.4 ± 3.3 years) either in JIA (p = .76) or control (p = .56). Patients enrolled had enthesitis-related arthritis in 6(12%), RF-positive polyarthritis in 8(16%), oligoarthritis in 32(64%), systemic arthritis in 2(4%) and psoriatic arthritis in 2(4%). Patients had higher CSHQ score (45.5 ± 8.2) and a lower KINDLR (72.4 ± 16.8) compared to the control (40.4 ± 3.4 and 78.3 ± 5.4; p < .0001 and p = .02 respectively). There were no differences between children and adolescents however, Sleep Onset Delay was significantly highest in systemic-onset children (p = .028) and KINDLR emotional subscale was significantly increased in those with oligoarthritis (81.6 ± 16.6) (p = .02). All subscales significantly correlated with their corresponding total score (p < .01). Age at onset” with Emotional subscale were predictive of poor sleep and with number of hospitalizations for poor quality of life. ConclusionsChildren and adolescents with inactive JIA, while taking medications, experience more disturbed sleep than matched control. This disturbance in their sleep entails in significant lower levels of HRQoL.