Sleep disturbances in patients with psoriatic arthritis

Abstract

Introduction/ObjectivesTo study quality of sleep in patients with psoriatic arthritis (PsA) and to investigate the association of sleep disturbances with other variables. Methodology and methodsPatients ≥18 years old with a diagnosis of PsA (CASPAR criteria). Sociodemographic and clinical data, physical exam. For each case, an age-sex matched control was included. The Pittsburgh Sleep Quality Index (PSQI) and the Patient Health Questionnaire-9 (PHQ-9) for depression were administered to both patients with PsA and controls. Statistical analysisDescriptive statistics. Univariate and multivariate analysis. Spearman correlation. Linear and multiple logistic regression. Results36 patients with PsA and 37 controls, 52.8% male, median age 57 years. Median PsA disease duration of 11 years. The ICSP was higher in patients with PsA than in controls (7.8±4.1 vs. 4.6±2.9, respectively, p<.001). A total of 27 patients (64.3%) presented sleep disturbances (ICSP≥5) vs. 15 controls (35.7%), p=.004. The presence of sleep disturbance in patients with PsA was associated with higher pain (6.5±2.4mm vs. 3.4±3.1mm, p=.01) and greater depression (PHQ-9 18 vs. 9, p=.05). The ICSP questionnaire correlated positively with PHQ-9, pain, night pain, MASES, PsAQoL, and DAPSA. In the linear regression analysis, both pain (β: .44, p=.01) and depression (β: .38, p=.03) were independently associated with sleep disorders. And in multiple logistic regression, the only variable independently associated with ICSP≥5 was pain (OR: 1.64, p=.023). ConclusionsMore than 60% of patients with PsA have sleep disturbance and the variables independently associated with it are pain and depression.