BackgroundThe aim of this study was to evaluate sleep quality and the related variables in patients with rheumatoid arthritis (RA).MethodsNinety-four patients diagnosed with RA and fifty two healthy controls were enrolled in the study. Disease activity was assessed through the Disease Activity Score (DAS) 28 scale. All patients were assessed using the Rheumatoid Arthritis Quality of Life and Health Assessment Questionnaire scales, together with the Beck Depression Inventory. Radiological damage was calculated with the modified Larsen method. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of the sleep disturbance.ResultsThe patients with RA had significantly higher scores in the subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance domains and the total PSQI score compared to the healthy control group. According to the results of Spearman’s analysis, there was a significantly correlation between the age, disease activity, CRP, pain, fatigue, depression, functional disability, quality of life, radiological damage, menopause status, duration of morning stiffness, ESR levels and the sleep disturbance. The logistic regression analysis indicated that depression and DAS 28 scores were predictors for poor sleep quality.ConclusionThe sleep quality is disturbed in patients with RA. The poor sleep quality is especially associated with the disease activity and depression.

Sleep quality is diminished in patients with PsA. Sleep disturbance is particularly associated with generalized pain, anxiety, enthesitis and levels of CRP and ESR in patients carrying the diagnosis of PsA.

Introduction Previous studies have shown that autonomic dysfunction is associated with shorter survival in patients with advanced cancer. We examined the association between heart rate variability (HRV), a measure of autonomic function, and survival in a large cohort of cancer patients. Methods We retrospectively examined the records of 651 cancer patients who had undergone ambulatory electrocardiogram (ECG) monitoring for 20–24 hours. Time domain HRV (standard deviation of normal-to-normal beat interval [SDNN]) was calculated using power spectral analysis. Survival data was compared between patients with SDNN ≥70 ms (Group 1, n = 520) and SDNN <70 ms (Group 2, n = 131). Results Two groups were similar in most variables, except group 2 patients had a significantly higher percentage of male patients (P=0.03), hematological malignancies (P=0.04), and use of non–selective serotonin reuptake inhibitor antidepressants (P=0.04). Patients in group 2 had a significantly shorter survival rate (25% patients in group 2 died by 18.7 weeks vs. 78.9 weeks in group 1; P <.0001). Multivariate analysis showed that SDNN<70 ms remained significant for survival (Hazard Ratio1.9, 95% Confidence Interval 1.4–2.5) independent of age, cancer stage and performance status. Conclusion The presence of cancer in combination with decreased heart rate variability (SDNN<70ms) is associated with shorter survival time.

Caregivers had an impaired emotional state and the level of their anxiety was associated with the severity of functional disability of the patients. Therefore, the support provided to the caregiver might be influential on the functional recovery of the patients.

Our results suggest that calprotectin might play an important role in the pathogenetic mechanisms of AS; however, the calprotectin levels did not correlate with the measurements of disease activity, functional abilities, radiological damage, and the quality of life in these patients. Further insight into this area of research might provide opportunities to develop novel treatment strategies, which take into account the role of these peptides in the pathogenetic mechanisms of AS.