MOS Sleep Scale Research Articles

Understanding the Mechanosensitivity of the Median Nerve in Pre-Surgical Carpal Tunnel Syndrome Patients: A Correlational Study

(1) Background: Neurodynamic tests are recommended for the diagnosis of entrapment neuropathies such as carpal tunnel syndrome (CTS). However, their association with clinical variables in severe patients or patients with associated comorbidities is poorly documented. This study aims to analyze the association between the mechanosensitivity of the median nerve and symptoms, function and psycho-social variables in moderate and severe carpal tunnel syndrome patients with comorbidities; (2) Methods: Correlational study. In total, 42 pre-surgical patients (24 females; 59.1 ± 12.7 years) included in the Spanish Public Healthcare System with an electrodiagnostic of CTS were selected. Sociodemographic variables and clinical features (symptoms, function, sensitivity and quality of life evaluated with the 36-item Short Form Survey (SF-36) and the Medical Outcomes Study Sleep Scale (MOS-sleep) were recorded. Upper Limb Neurodynamic Test 1 was used to evaluate neural mechanosensitivity; (3) Results: The 81% had a severe CTS and 78.6% had some comorbidity. The average time from the first medical visit to the surgeon’s visit was 365.5 days. Median nerve mechanosensitivity correlated weakly with the SF-36 subscale, General Health, (Spearman’s rho = 0.367) and MOS sleep scale, Awaken Short of Breath or with headache dimension (Spearman’s rho = −0.353) and moderately with SF-36 subscale, Social Functioning (Spearman’s rho = 0.553); (4) Conclusions: No associations were observed for median nerve mechanosensitivity, except for quality of life and sleep. Both social determinants and clinical variables should be considered when examining and treating these patients.

Omalizumab improves sleep and health status for patients with chronic rhinosinusitis with nasal polyps: An analysis of randomized clinical trials.

Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have high incidence of sleep impairment. We evaluated the impact of omalizumab treatment on sleep characteristics and associated health status in patients with CRSwNP. Prespecified exploratory analysis assessed outcomes from patients included in the POLYP 1 and POLYP 2 phase 3 clinical trials and the open-label extension. Sleep was assessed by the sleep domain of the Sino-Nasal Outcome Test-22 (SNOT-22; MCID>4 in patients with CRS) and the Medical Outcomes Study Sleep Scale (MOS-Sleep). Health status was assessed by Healthy Days Core Module (HDCM) and sinonasal-specific Patient Global Impression of Change (PGIC). Omalizumab improved sleep as assessed by the SNOT-22 sleep domain. At week 24, adjusted mean (95%CI) SNOT-22 sleep scores had reduced from baseline by -8.5 (-9.9 to -7.1) with omalizumab versus -2.7 (-4.1 to -1.3) with placebo. At week 52 (all patents on OMA), adjusted mean (95%CI) SNOT-22 sleep scores had reduced from baseline by -10.1 (-11.4 to -8.7) with omalizumab. Improvements were observed in all eight items of the SNOT-22 sleep domain: difficulty falling asleep, fatigue, frustration/restlessness/irritability, lack good night's sleep, reduced concentration, reduced productivity, wake up tired, and wake up at night. In addition, omalizumab improved six of eight sleep outcomes on the MOS-Sleep scale. There were concurrent improvements in HDCM and PGIC. Omalizumab improved sleep and self-reported health status in patients with CRSwNP. This contributes to evidence that omalizumab provides value for patients beyond the reduction of sinonasal symptoms.

Quantum Molecular Resonance Radiofrequency Disc Decompression and Percutaneous Microdiscectomy for Lumbar Radiculopathy.

Within the practice of pain management, one of the most commonly encountered events is low back pain. Lumbar radiculopathy (LR) is a pain syndrome caused by the compression or irritation of the nerve roots in the lower back due to lumbar disc herniation, vertebra degeneration, or foramen narrowing. Symptoms of LR include low back pain that propagates toward the legs, numbness, weakness, and loss of reflexes. The aim of this study is to assess the long-term effectiveness of quantum molecular resonance disc decompression and its combination with a percutaneous microdiscectomy using Grasper© forceps (QMRG) in patients with persistent lumbar radiculopathy (LR) in relation to patient physical stress status. The main outcome measures of this prospective observational study were DN4, NRS, ODI, SF12, PGI, CGI, and MOS Sleep Scale. An improvement 12 months post-intervention was observed in patients without physical stress, presenting better overall results. The mean change was over the minimal clinically important difference in 64.3% of outcome measures studied for the whole sample. QMRG appears to be an effective treatment option for LR, but a reduction in physical stress is needed to ensure long-term effectiveness.

Dupilumab Demonstrates Rapid Onset of Action in Improving Signs, Symptoms and Quality of Life in Adults with Atopic Dermatitis.

Dupilumab has significantly improved the signs, symptoms and quality of life (QoL) of patients with moderate-to-severe atopic dermatitis (AD) in randomised, controlled clinical trials. However, there is a need to assess the effectiveness and safety of dupilumab in real-world clinical practice. The PROLEAD study was designed to examine the effectiveness and safety of dupilumab in moderate-to-severe AD in a real-world setting in Germany. Here, we present 12-week effectiveness and safety results with dupilumab from PROLEAD. PROLEAD is a multicentre, prospective, non-interventional study being conducted at 126 routine care sites across Germany. Adults with moderate-to-severe AD who require systemic therapy were treated with dupilumab as indicated by the Summary of Product Characteristics. Data collected included physician assessments (EASI, BSA, SCORAD, and IGA) and patient-reported outcomes (PROs [POEM, DLQI, EQ-5D-5L, Peak Pruritus NRS and MOS Sleep Scale]). Of 839 patients assessed for eligibility, 828 were included. The full analysis and safety analysis sets comprised 775 and 818 patients, respectively. The number of patients receiving concomitant therapy decreased from baseline to Week 12. Mean (standard deviation [SD]) percentage change in EASI score from baseline to Week 12 was -67.5% (48.4%) and was comparable across the four body regions. The proportion of patients achieving EASI-75 was 59.4% at Week 12. Mean (SD) Peak Pruritus NRS decreased from 7.4 (2.3) at baseline to 3.4 (2.6) at Week 12. Improvements from baseline to Week 12 were reported in all PROs assessed. No new safety signals were observed. Improvements in efficacy outcomes and adverse event rates in a real-world setting were more favourable than in phase 3 clinical trials. The 12-week findings of PROLEAD demonstrate that treatment with dupilumab is effective and well tolerated, with rapid onset of action in signs, symptoms and QoL in patients with moderate-to-severe AD in the realworld. DUPILL08907; NIS-Nr. 433.

A randomized controlled trial assessing the safety and efficacy of palmitoylethanolamide for treating diabetic-related peripheral neuropathic pain

BackgroundPeripheral neuropathy is a common complication of diabetes. The management of the associated neuropathic pain remains difficult to treat.ObjectiveThis study explored the safety, tolerability and efficacy of a palmitoylethanolamide (PEA) formulation in treating diabetic-related peripheral neuropathic pain (PNP). Secondary outcomes included systemic inflammation, sleep and mood changes in patients diagnosed with type 1 and type 2 diabetes and PNP.DesignThis study was a single-centre, quadruple-blinded, placebo-controlled trial with 70 participants receiving 600 mg of PEA or placebo daily, for 8 weeks, with a 94% rate of study participation completion. Primary outcomes were neuropathic pain and specific pain types (the BPI-DPN and NPSI). The secondary outcomes were sleep quality (MOS sleep scale), mood (DASS-21), glucose metabolism and inflammation.ResultsThere was a significant reduction (P ≤ 0.001) in BPI-DPN total pain and pain interference, NPSI total score and sub-scores, except for evoked pain (P = 0.09) in the PEA group compared with the placebo group. The MOS sleep problem index and sub-scores significantly improved (P ≤ 0.001). DASS-21 depression scores significantly reduced (P = 0.03), but not anxiety or stress scores. Interleukin-6 and elevated C-reactive protein levels significantly reduced in the PEA group (P = 0.05), with no differences in fibrinogen between groups (P = 0.78) at treatment completion. There were no changes in safety pathology parameters, and the treatment was well tolerated.ConclusionsThe study demonstrated that the PEA formulation reduced diabetic peripheral neuropathic pain and inflammation along with improving mood and sleep. Further studies on the mechanistic effectiveness of PEA as an adjunct medicine and as a monotherapy pain analgesic are warranted.Clinical Trial RegistrationRegistry name: Australian New Zealand Clinical Trials Registry (ANZCTR), Registration number: ACTRN12620001302943, Registration link: https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380826, Actual study start date: 20 November 2020.

Sleep disturbances in the irritable bowel syndrome and functional dyspepsia are independent of psychological distress: a population-based study of 1322 Australians.

Psychological distress, strongly associated with functional gastrointestinal disorders (FGIDS), likely plays a central role in the pathophysiology. The role of sleep disturbances in FGIDs is unclear, and an association with psychological factors is uncertain. To determine whether sleep disturbances are associated with irritable bowel syndrome (IBS) and functional dyspepsia (FD) and if a potential association is explained by psychological distress. Adult sample randomly selected from a region in New South Wales, Australia in 2015 who returned a follow-up mail survey in 2018 (response rate, 60.5%) that contained questions on IBS, FD, sleep (MOS-Sleep Scale) and psychological distress (Kessler 6 scale). Among this population, 10.4% (95% CI 8.8-12.2) and 17.9% (95% CI 15.9-20.1) met Rome III criteria for IBS and FD, respectively. The prevalence of any sleep disturbance at least most of the time was common, with a significantly higher prevalence in FGID (IBS and/or FD) compared with the remaining population (41.8% vs 32.2%, P=0.003). The total sleep problem index was significantly higher for IBS (OR=1.71 [95% CI 1.29-2.27], P<0.0001) (IBS-diarrhoea predominant and IBS-mixed but not IBS-constipation) and FD (OR=1.80 [1.43-2.26], P<0.0001) (both epigastric pain syndrome and postprandial distress syndrome) even after adjusting for age, sex and psychological distress. Both IBS and FD, and most of their major subtypes except IBS-C, are associated with a range of sleep disturbances. These sleep problems do not appear to be explained by psychological factors and may play an independent role in the pathophysiology.

The development and validation of a revised version of the Medical Outcomes Study Sleep Scale (MOS Sleep-R)

BackgroundThe 12-item Medical Outcomes Study Sleep Scale (MOS Sleep Scale) has been used to capture patient-reported sleep problems in hundreds of studies. A revised version of the MOS Sleep Scale (MOS Sleep-R) was developed that uses simplified response sets, provides interpretable norm-based scoring, and has two recall versions (one-week or four-week). The objective of this study was to evaluate the psychometric properties (reliability and construct validity) of the MOS Sleep-R using data from a representative sample of U.S. adults.MethodsStandardization of raw scores into norm-based T-scores (mean = 50, standard deviation = 10) was based on data from a 2009 U.S. internet-based general population survey. The internal consistency reliability of multi-item subscales and global sleep problems indices for both one-week and four-week recall forms of the MOS Sleep-R were examined using Cronbach’s alphas and inter-item correlations. Construct validity was tested by comparing item-scale correlations between items within subscales with item-scale correlations across subscales. Scale-level convergent validity was tested using correlations with measures including generic health-related quality of life (i.e., SF-36v2) and other relevant outcomes (e.g., job performance, number of days in bed due to illness or injury, happiness/satisfaction with life, frequency of stress/pressure in daily life, the impact of stress/pressure on health, and overall health).ResultsThe one-week and four-week recall forms of the MOS Sleep-R were completed by 2045 and 2033 respondents, respectively. The psychometric properties of the one-week and four-week forms were similar. All multi-item subscales and global index scores showed adequate internal consistency reliability (all Cronbach’s alpha > 0.75). Patterns of inter-item and item-scale correlations support the scaling assumptions of the MOS Sleep-R. Patterns of correlations between MOS Sleep-R scores with criterion measures of health-related quality of life and other outcomes indicated adequate construct validity.ConclusionsThe MOS Sleep-R introduces a number of revisions to the original survey, including simplified response sets, the introduction of a one-week recall form, and norm-based scoring that enhances interpretability of scores. Both the one-week and four-week recall period forms of the MOS Sleep-R demonstrated good internal consistency reliability and construct validity in a U.S. general population sample.

Sleep Characteristics in Diabetic Patients Depending on the Occurrence of Neuropathic Pain and Related Factors.

This study aims to compare the sleep characteristics (structure and quality) in patients with type-2 diabetes mellitus with and without diabetic neuropathic pain (DNP), and to investigate the relationship of sensory phenotypes, anxiety, and depression with sleep quality in DNP patients. A cross-sectional study was performed in patients with type-2 diabetes mellitus and neuropathy. Patients were classified into two groups—with or without neuropathic pain—according to the “Douleur Neuropathique-4 (DN4)” scale. Sleep characteristics and quality (Medical Outcomes Study—MOS-sleep), pain phenotype (Neuropathic Pain Symptom Inventory—NPSI), mood status (Hospital Anxiety and Depression scale—HADS), pain intensity (Visual Analogue Scale—VAS), and quality of life (SF-12v2) were measured. The sample included 130 patients (65 with DNP). The mean scores in all the dimensions of the MOS-sleep scale were higher (more disturbances) in the DNP patients. Higher scores in anxiety or depression, greater intensity of pain or a higher score in the paroxysmal pain phenotype were associated with lower sleep quality in DNP patients. A shorter duration of the diabetes and lower levels of glycated hemoglobin were also associated with lower sleep quality. The results show the relationship between DNP and sleep quality, and the importance of assessing sensory phenotypes and mental comorbidities in these patients. Taking these factors into consideration, to adopt a multimodal approach is necessary to achieve better clinical results.

Sleep disturbances in ankylosing spondylitis: a systematic review and meta-analysis

ABSTRACTThe aim of this meta-analysis was to compare sleep outcomes of AS patients and controls. Six electronic databases were searched: PubMed, Embase, IndMed, Cochrane Library, CNKI and Web of Science. Statistical analyses were executed using Revman 5.3 software. Nine studies and a total of 3169 participants were included in the meta-analysis. When sleep was assessed using PSQI, significant differences were observed in subjective sleep quality, sleep latency, sleep efficiency, sleep disorders, sleep medication use and total PSQI between patients with AS and controls, and subjective sleep quality was most severely affected. In PSG, eight variables of sleep quality (stage I sleep, stage II sleep, slow wave sleep, rapid eye movement, arousal index, periodic leg movement index, sleep latency, sleep efficiency) were lower in AS patients than in controls. Three variables of sleep quality assessed by USI (estimated sleep time, sleep sufficiency index, number of awakenings per night) and two variables of sleep quality assessed by MOS sleep scale (sleep disturbance scale, sleep problem index II) were lower in AS patients than in controls. It indicated that AS patients experience more serious sleep disorders. Early recognition and appropriate interventions are essential to improve patients’ sleep quality.

Tobacco Use in Fibromyalgia Is Associated With Cognitive Dysfunction: A Prospective Questionnaire Study.

ObjectiveTo evaluate the association between smoking and cognitive function in patients with fibromyalgia.Patients and MethodsWe surveyed 668 patients with fibromyalgia from May 1, 2012 through November 30, 2013 at a major tertiary referral center. Patients were categorized by smoking status. Primary outcome of interest was cognitive function (MASQ questionnaire), and secondary outcomes included fibromyalgia symptom severity (FIQ-R questionnaire), quality of life (SF-36 questionnaire), fatigue (MFI-20 questionnaire), sleep (MOS-sleep scale), anxiety (GAD-7 questionnaire), and depression (PHQ-9 questionnaire). Independent Students' t-tests and χ2 tests were performed for continuous and categorical variables, respectively. Univariate regression analysis identified variables predictive of outcomes, adjusting for age, gender, body mass index, marital status, and educational level.ResultsNinety-four (14.07%) patients self-identified as smokers. There was an association of lower education level, unmarried status, and younger age in smokers compared with nonsmokers. In the adjusted univariate regression analysis, fibromyalgia smokers reported greater perceived total cognitive dysfunction (P=.009) and greater subscale scores of perceived difficulty in language (P=.03), verbal memory (P=.003), visual-spatial memory (P=.02), and attention (P=.04) compared with nonsmokers with fibromyalgia. For secondary outcomes, smokers with fibromyalgia reported greater severity of fibromyalgia-related symptoms (P=.006), worse quality-of-life index in the mental component scale (P=.02), greater sleep problems (P=.01), and increased anxiety (P=.001) compared with nonsmokers who had fibromyalgia.ConclusionIn patients with fibromyalgia, smoking is a risk factor for cognitive dysfunction. Moreover, smokers with fibromyalgia were more likely to report increased severity of fibromyalgia symptoms, worse quality of life, more sleep problems, and increased anxiety compared with nonsmokers with fibromyalgia.

Abstract WP234: Seasonal Differences in Sleep and Incident and Recurrent Strokes: Evidence From the Stroke Warning Information and Faster Treatment (SWIFT) Study

Introduction: Studies have documented seasonal patterns in stroke outcomes. While results are equivocal most report increased rates of these outcomes in the winter-spring and hypothesize this is explained by ambient temperature. Sleep disturbance, which also varies by season, may also explain this pattern. In this analysis we leverage a unique cohort to test whether incident or recurrent strokes vary by season, and whether this co-varies with sleep disturbance. Methods: Data comes from SWIFT, a stroke preparedness RCT conducted in northern Manhattan. Season of stroke was classified as winter (W; Dec - Feb), spring (Sp; Mar - May), summer (Su; Jun - Aug), fall (F; Sept - Nov). We restricted our analysis to the period Feb 2005 - Jan 2009. Incident strokes were individuals enrolled at baseline without radiological or clinical evidence of prior stroke. Recurrent strokes were captured as part of follow-up protocol. Sleep was measured with the MOS sleep scale, a 12 item questionnaire that produces 8 validated scales. For brevity, we report results using the sleep problem index 2 (9 questions). We assessed seasonal variation in stroke incidence using a one-way goodness of fit chi-square test assuming a distribution based on the number of days per season. The relationship between seasonal variation in stroke and sleep was assessed using ANOVA. Results: A total of 835 incident strokes were enrolled (25% white, 15.5% black, 53.1% Hispanic, 6.4% other; 49.8% female; mean age 63.4±15.6). Incident stroke was not significantly different by season (24.3% W; 22.8% Sp; 28.6% Su; 24.3% F; p=0.09). Mean sleep problems did not vary by season (32.3 W; 30.8 Sp; 31.9 Su; 31.4 F; p=0.86) for incident strokes. A total of 120 first recurrent strokes were captured (20.8% white, 17.5% black, 5% Hispanic, 6.7% other; 49.2% female; mean age 66.0±15.0). Recurrent stroke was significantly different by season (21.7% W; 14.2% Sp; 36.7% Su; 27.5% F; p&lt;0.01). Mean sleep problems did not vary by season (32.4 W; 29.9 Sp; 31.7 Su; 35.1 F; p=0.70) for recurrent strokes. Conclusion: We find no variation in incident strokes but an increased proportion of first recurrent strokes in the summer. Neither incident nor recurrent strokes co-varied with sleep problems. Future studies in non-urban samples are warranted.

Severity of allergic rhinitis impacts sleep and anxiety: results from a large Spanish cohort

BackgroundAllergic rhinitis (AR) is a highly prevalent disease that generates high social and health care costs and also has a significant effect on quality of life and quality of sleep. It has also been related to some psychological disorders like anxiety or depression.ObjectiveTo evaluate anxiety, depression, and quality of sleep and life alteration in a group of patients with perennial AR compared to a group of seasonal AR patients.MethodsSix-hundred seventy adults (> 18 years) with perennial and seasonal AR were recruited consecutively in 47 centers in Spain. Individuals were grouped in “Perennial” and “Seasonal” according to the seasonality of their symptoms. Anxiety, depression, sleep quality and health related quality of life were evaluated using the Hospital Anxiety and Depression Scale, Medical Outcomes Study Sleep Scale (MOS Sleep Scale) and the Health-related quality of life questionnaire ESPRINT-15, respectively. Both groups of patients were evaluated in and out of the pollen season.ResultsAR symptoms are related to worse quality of life and more anxiety and depression symptoms. Indeed, symptom severity also correlates with worse outcomes (quality of life, sleep and depression/anxiety) regardless allergen seasonality. Symptoms severity, compared with seasonality and persistence, is the most important factor related with more anxiety and depression and poor sleep. However, symptoms severity, persistence and seasonality are independently affecting the quality of life in patients with AR.ConclusionsAlthough AR symptoms have a great impact on depression and anxiety symptoms, quality of life and quality of sleep in all AR patients, as expected, individuals with more severe AR seem to suffer more intensely their effects.

Sex-related demographic and symptomatologic characteristics of patients with fibromyalgia

To assess sex-related characteristics in patients with fibromyalgia, specifically in terms of patient demographics (age, body mass index, marital status, and educational level), tender point count, symptoms (cognition, sleep disorder, fatigue, anxiety, and depression), and quality-of-life measurements. We studied 668 consecutive patients (606 women) who participated in the Fibromyalgia Treatment Program at Mayo Clinic (Rochester, Minnesota) from May 2012 through November 2013. All patients completed a series of questionnaires at the initial consult, including the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Medical Outcomes Study Sleep Scale (MOS-Sleep Scale), the Revised Fibromyalgia Impact Questionnaire (FIQ-R), the Multidimensional Fatigue Inventory (MFI-20), the Multiple Ability Self-Report Questionnaire (MASQ), and the 36-item Short-Form Health Survey (SF-36). Non-parametric Wilcoxon rank test and the Chi 2 test for continuous variables and categorical variables were used to detect differences between sexes. We observed no significant sex-based differences in demographics, including age, marital status, and educational level. Likewise, no significant sex differences were seen in body mass index, mood, sleep, cognition, symptom impact, or fatigue. However, women had a significantly higher tender point count than men ( P = 0.001). The only sex-related difference observed in our cohort was the tender point count; the assumption of other sex-based differences in the clinical presentation of fibromyalgia was not supported in our study.

Abstract W MP72: Sleep and Timing of Recurrent Events in a Mild Stroke Population: Results of the SWIFT Study

Sleep is an important contributor to cardiovascular disease; we have previously reported it is a risk factor for incident vascular events. It is thought that sleep apena may be the primary mechanism through which sleep disturbance is associated with vascular events. Little is known, however, about the association between sleep and recurrent events. The aim of this analysis was to determine the association between sleep problems and the risk of recurrent vascular events in an elderly, multiethnic population. This analysis uses data from SWIFT, a randomized clinical trial conducted in northern Manhattan designed to test a stroke preparedness intervention. Sleep was measured with the MOS sleep scale. MOS is a 12 item questionnaire that produces 8 validated scales. We report results using the snoring (1 question), shortness of breath during sleep (1 question), and sleep problem index 2 (9 questions) scales. Outcomes were collected prospectively through active surveillance. We used Cox Models to test whether our measures of sleep were associated with an increased hazard of having a recurrent event. SWIFT randomized 1193 stroke participants: mean age 63 years +- 15.14; 50% female; 17% black, 51% Hispanic, 26% white, 6% other. In models adjusted for treatment assignment, race, age, gender, education, marital status and baseline measures of hypertension, diabetes, smoking and NIH stroke scale the sleep problems index 2 was associated with an increased hazard of a first recurrent stroke or TIA (HR=1.91, p-value=0.02), whereas our measures of snoring (HR=1.20, p-value=0.43) and shortness of breath during sleep (HR=1.39, p-value=0.46) were not. The same pattern of results held for a composite measure of first recurrent stroke, TIA, MI or vascular death: sleep problems index 2 (HR=1.97, p-value=0.003), snoring (HR=1.10, p-value=0.62) and shortness of breath during sleep (HR=1.59, p-value=0.18). Our results highlight the contribution of sleep to the risk of recurrent vascular events in a population of mild and moderate stroke/TIA survivors. Importantly, this result is not driven by snoring or trouble breathing at night and is independent of hypertension, smoking and diabetes.

RLS patients can also develop compulsions on dopaminergic agonists

Introduction The aim of this study was to assess the frequency of self-reported compulsive behaviours, depressive and stress symptoms and sleep disorders in a population of Restless legs patients treated with DA agonists. Reports by Tippmann-Peikert et al. (2007) and Ritz et al. (2006) extend the risk of developing DA agonists related impulse control disorders such as gambling, heightened sexual drive or unreasonably overinvested repetitive activities to RLS patients. Materials and methods A questionnaire covering RLS severity (IRLSSG-Walters et al. 2003), mood variables, The Beck Depression Inventory II (Beck et al. 2003), a visual Analog Scale of current level of stress and sleep parameters (The MOS Sleepscale, Hays & Stewart 1992) was sent at 3 points in time over twelve months in 2005 (February, June, October) to 150 RLS patients cared for at the Quebec Memory & Motor Skills Disorders Clinic. A last section exploring changes in hobbies, development of new habits and compulsions was added at the third mailing. Results Data derived from a population of 97 patients having answered all three mailings identified 17 positive responses to compulsions. After re-evaluation only 12 (8 women and 4 men) were found to have truly compulsive behaviours. In two women, simple motor stereotyped sequences in response to sensory urge evoked the phenomenology of Gilles de La Tourette Syndrome. In two other, one male, one female, a reactivation of trichotillomania previously exhibited in childhood was observed. For the other eight patients, abnormal behavioural display was similar to complex compulsory behaviours with short-term rewarding properties such as buying clothes, buying food, eating or gambling. In addition BDI and stress scores significantly contrasted the compulsion (+) vs. compulsion (−) patients. Their MOS sub-scale sleep problem Index I and II showed significantly higher scores and finally, the augmentation phenomenon was of higher prevalence in the C + group at the time of the 3rd questionnaire. Conclusion In summary, 12 out of 97 RLS patients on stable DA agonist therapy presented with progressive dishinibition of behaviour possibly shaped by pre treatment gender and individual specificities. None had a previous diagnosis of anxious generalized disorder or obsessive compulsive disorder. They showed more dysphoric and recognized themselves as more stressed than the compulsion (-) group of RLS patients.

Chronic Pain with Neuropathic Characteristics in Diabetic Patients: A French Cross-Sectional Study

ObjectiveOur aim was to estimate the prevalence of distal chronic pain with neuropathic characteristics in patients with type 1 and type 2 diabetes mellitus and its impact on quality of life, mood, anxiety, sleep and healthcare utilization.MethodsIn total, 885 patients were screened and 766 diabetic patients (38.7% with type 1 diabetes mellitus, 44.8% women, mean age: 57.2±14.9 years) were enrolled consecutively over a three-month period in this observational study by 85 diabetes specialists working in a hospital department or in private practice. All the patients completed a series of questionnaires for the detection of chronic pain (i.e. daily pain for more than three months) in the lower limbs and assessment of health-related quality of life (Medical Outcomes Short Form 12 scale), sleep disturbances (MOS sleep scale), depression and anxiety (Hospital Anxiety and Depression scale). Patients with chronic pain were also assessed with the 7-item DN4-interview questionnaire, the monofilament test and the Michigan Neuropathy Screening Instrument (MNSI).ResultsThe overall prevalence of chronic pain with neuropathic characteristics was 20.3% [95% CI 17.4–23.1]. The MNSI examination score suggested that pain was related to polyneuropathy, in 80.1% of these patients (89.5% of those with bilateral pain). Patients with chronic pain had a poorer quality of life and more sleep disturbances, anxiety and depression than patients without pain and the presence of neuropathic characteristics was predictive of such impairments. Only 38.6% of the patients had received appropriate treatment for neuropathic pain.ConclusionsChronic pain with neuropathic characteristics concerns one in five diabetic patients, has a significant impact on quality of life and is not adequately managed. The close correlation between the DN4 questionnaire and MNSI results suggests that screening tools for neuropathic pain could be used in daily practice for the identification of painful diabetic polyneuropathy.

THU0151 Effects of tofacitinib (CP-690,550), an oral janus kinase inhibitor, or adalimumab on patient reported outcomes in a phase 3 study of active rheumatoid arthritis

BackgroundTofacitinib (CP-690,550) is a novel, oral Janus kinase (JAK) inhibitor being investigated as a targeted immunomodulator and disease-modifying therapy for rheumatoid arthritis (RA).ObjectivesTo compare the effects of tofacitinib 5 and...

AB0912 The introduction of ankylosing spondylitis annual review clinics at a london teaching hospital

BackgroundNational U.K recommendations1 have led to the introduction of annual review clinics for patients with rheumatoid arthritis. We considered the benefits of ankylosing spondylitis annual review clinics.ObjectivesReview the diagnosis of...

FRI0452 Determinants factors of sleep disturbances in spondylarthritis

BackgroundLiterature data suggest that sleep disturbances are prevalent among patients with Spondylarthritis (Spa) and have a close correlation with pain and psychological status.Objectivesour study was designed first to evaluate sleep...

THU0360 Rapid Improvements in Patient-Reported Outcomes with Certolizumab Pegol in Patients with Axial Spondyloarthritis, Including Ankylosing Spondylitis: 24-Week Results of Rapid-Axspa Study

BackgroundAxial spondyloarthritis (axSpA) includes both ankylosing spondylitis (AS) and axSpA with no definitive sacroiliitis on X-ray (non-radiographic axSpA, nr-axSpA). These patients (pts) subgroups have similar clinical disease burden,1 however, the...