Abstract
We aimed to assess the subjective sleep quality in patients with rheumatoid arthritis (RA) and its correlation with disease activity, pain, inflammatory parameters, and functional disability. In a cross-sectional study, patients with confirmed RA diagnosis responded to a questionnaire (consisting of socio-demographic data, the Health Assessment Questionnaire Disability Index, and the Medical Outcome Study Sleep Scale). Disease activity was assessed with the Clinical Disease Activity Index, and pain levels using the visual analogue scale. In addition, inflammatory markers (C-reactive protein, interleukin-6, and tumor necrosis factor alpha) were analyzed. Ninety-five patients were analyzed, predominantly female, with an average age of 50.59 (9.61) years. Fifty-seven percent reported non-optimal sleep duration, where functional disability (92.7% vs. 69.8%; p = 0.006) and higher median pain levels (3.75 (2.3–6.0) vs. 2.5 (2.0–3.5); p = 0.003) were also more prevalent. No differences in sociodemographic variables, disease duration or activity, inflammatory parameters, or use of biological and corticosteroid therapy were observed. The multivariate regression analysis showed that more intense pain was associated with a lower likelihood of optimal sleep (odds ratio (OR) = 0.68, 95% confidence interval (CI) 0.47–0.98, p = 0.038). Patients with RA report a high prevalence of non-optimal sleep, which is linked to pain level. Clinicians need to be aware of this issue and the potential effects on health and functional status.
Highlights
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by changes in the synovium followed by joint swelling, pain, cartilage and bone destruction, and subsequent systemic inflammation [1]
Differences according to optimal sleep duration were found in pain intensity, level of functional disability, and use of non-steroidal anti-inflammatory drugs (NSAID) and disease-modifying drugs
In an investigated sample of patients with rheumatoid arthritis (RA), problems with sleep are common, with 56.8% of the participants reporting non-optimal sleep duration
Summary
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by changes in the synovium followed by joint swelling, pain, cartilage and bone destruction, and subsequent systemic inflammation [1]. The incidence of RA has proven difficult to determine due to the wide variety of symptoms with which patients seek medical help and the associated delay in seeking medical help. The prevalence of RA has been reported at around 1% globally, with some countries showing reduced prevalence [3]. The disease is more prevalent in women and has been found to increase in prevalence with age, with the highest rates found in women older than 65 years [2]. Patients with RA have a higher mortality and morbidity burden, reduced quality of life, and higher disability [4]
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