Rheumatoid arthritis and sleep quality

Goes, Ana Claudia Janiszewski; Reis, Larissa Aparecida Busatto; Silva, Marilia Barreto G.; Kahlow, Bárbara Stadler; Skare, Thelma Larocca

doi:10.1016/j.rbre.2016.07.011

Cited by 42 publications

(42 citation statements)

References 20 publications

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“…Overall, in our study factors influencing sleep quality, such as oral sicca, pain and depression, may have a negative effect on HRQoL. Patients typically experience difficulty in falling asleep, early morning wakening, and fragmented sleep with frequent nocturnal awakenings relative to controls, which is similar to the results from rheumatoid arthritis . Frequent awakenings during the night were noted by pSS patients and this was associated with various symptoms, such as pain, headache, shortness of breath, palpitations and sweating.…”

Section: Discussionsupporting

confidence: 74%

“…Patients typically experience difficulty in falling asleep, early morning wakening, and fragmented sleep with frequent nocturnal awakenings relative to controls, which is similar to the results from rheumatoid arthritis. 18 Frequent awakenings during the night were noted by pSS patients and this was associated with various symptoms, such as pain, headache, shortness of breath, palpitations and sweating. Patients with pSS more often reported they did not feel rested after sleep and felt sleepy during the day.…”

Section: Ta B L E 2 Sleep Quality Differences Between Pss and Healthymentioning

confidence: 99%

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Prevalence, correlates, and impact of sleep disturbance in Chinese patients with primary Sjögren’s syndrome

Cui

et al. 2019

Int J of Rheum Dis

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Aim Sleep disturbances are common in primary Sjögren's syndrome (pSS) patients and may lead to disease aggravation and decreased health‐related quality of life (HRQoL). There are currently no known reported studies related to the prevalence, correlates, and impact of sleep disturbance in pSS patients from China. Therefore, this study aims to assess the sleep quality in Chinese pSS patients and evaluate its relationship with the disease activity, quality of life and mood disorders. Methods A self‐report survey was administered to 221 pSS patients and 198 healthy individuals using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. Disease activity and damage were evaluated with the European League Against Rheumatism Sjögren's syndrome disease activity index (ESSDAI). Independent samples t tests, Chi‐square analysis, logistic regression were used to analyze these data. Results Our results found that the prevalence of poor sleep (PSQI ≥ 6) was 57.5% and the mean global score of PSQI was 6.57 (SD 3.19) in patients, which were significantly higher than the controls (32.3% and 4.93 [SD 2.86], respectively). When trying to fall asleep, patients with pSS had some sleep disturbances, reduced sleep efficiency, increased number of awakenings than controls. There were significant correlations among dryness, ocular surface disease, HRQoL, pain, disease activity, anxiety/depression and sleep quality in pSS patients. Meanwhile, logistic regression models identified depression and Short Form‐36 mental composite score as predictors of poor sleep quality. Conclusions Sleep disturbances are commonly reported in pSS patients and sleep quality is lower in pSS patients than in healthy controls. The data suggested the need for holistic assessment and management of pSS patients.

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Section: Discussionsupporting

confidence: 74%

Section: Ta B L E 2 Sleep Quality Differences Between Pss and Healthymentioning

confidence: 99%

Prevalence, correlates, and impact of sleep disturbance in Chinese patients with primary Sjögren’s syndrome

Cui

et al. 2019

Int J of Rheum Dis

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“…Importantly, poor sleep quality may contribute to greater pain, disease activity and mood disorders, creating a cascade of dysfunction for afflicted patients [8, 9]. It has been recognized that a number of influences, such as socioeconomic status, disease activity and psychological disorders may impact sleep health, which is common in the RA population [10, 11]. …”

Section: Introductionmentioning

confidence: 99%

Sleep quality in Chinese patients with rheumatoid arthritis: contributing factors and effects on health-related quality of life

Guo

Yin

et al. 2016

Health Qual Life Outcomes

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BackgroundPoor sleep quality is common in rheumatoid arthritis (RA) patients and may lead to disease aggravation and decreased health-related quality of life (HRQoL). The increasing prevalence of poor sleep in RA patients is associated with adverse demographic, clinical, and psychological characteristics. However, there are currently no known reported studies related to the effects of sleep quality on HRQoL in RA patients from China. This cross-sectional study aims to evaluate the contributors of poor sleep and the effects of sleep quality on HRQoL in Chinese RA patients.MethodsA self-report survey was administered to 131 RA patients and 104 healthy individuals using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. RA patients completed the Hospital Anxiety and Depression Scale for anxiety and depression, the 28-joint Disease Activity Score for disease activity, the 10 cm Visual Analog Scale for pain, the Health Assessment Questionnaire-Disability Index for functional capacity and the Short Form 36 health survey for HRQoL. Blood samples were taken to gain some biochemical indicators (e.g., erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and anti-cyclic citrullinated peptide). Independent samples t-tests, Chi square analysis, logistic regression modeling and linear regression were used to analyze these data.ResultsOur results found that the prevalence of poor sleep (PSQI ≥ 5) was 78.6% and the mean global score of PSQI was 7.93 (SD 3.98) in patients, which were significantly higher than the controls (18.7% and 3.88 (SD 1.89), respectively). There were significant correlations among synthetic disease-modifying antirheumatic drugs, erythrocyte sedimentation rate, pain, disease activity, functional capacity, anxiety/depression and sleep quality in RA patients. Meanwhile, logistic regression models identified disease activity and depression as predictors of poor sleep quality. Poor RA sleepers had impaired HRQoL than good RA sleepers, and sleep quality was independently and significantly associated with social function and mental components summary.ConclusionsThe majority of Chinese RA patients suffered from poor sleep, which significantly impairs their HRQoL. The data suggested the need for holistic assessment and management of RA patients and the importance of objective interventions to improve their sleep quality and finally to improve their HRQoL.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-016-0550-3) contains supplementary material, which is available to authorized users.

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“…Most of RA patients do not have a good sleep quality. Several studies have found sleep fragmentation, low sleep efficiency, frequent awakenings and poor sleep quality in this group of patients [29]. Sleep is often considered a state of the brain that improves immune function.…”

Section: Balance Between Exercise and Restmentioning

confidence: 89%

Five Balances in the Management of Rheumatoid Arthritis

Zou¹

2017

JBM

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Rheumatoid arthritis (RA) is the most common chronic autoimmune joint disease. The etiology of RA is complex, and then it is impossible to cure completely today and it should be individualized treatment. Immune system is complex. Existing statistical techniques based on reductionism cannot discover many relevant disease risk factors and complex interaction relationship. The disease network model based on complex network is important for the analysis and treatment of RA disease. In this Review, we have found five important layers of RA complex network and presented five balances regulating strategy in the management of RA. We have followed up one RA patient (wife of the author) for one year using this strategy, and the management effect is good. This Review argues RA is self-limiting to some extent, and good management with five balances regulating strategy would have positive significance, among which the balance between neuroendocrine system and immune system is the most important. During the day, glucocorticoid plays an important role in controlling inflammation, and human growth hormone plays an important role in eliminating inflammation during the slow-wave sleep at night. Five balances core concepts can shed light on the management of other causes of arthritis.

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Rheumatoid arthritis and sleep quality

Abstract: Most of RA patients do not have a good sleep quality. Depression and risk of sleep apnea are independently associated with sleep impairment.

Cited by 42 publications

References 20 publications

Prevalence, correlates, and impact of sleep disturbance in Chinese patients with primary Sjögren’s syndrome

Prevalence, correlates, and impact of sleep disturbance in Chinese patients with primary Sjögren’s syndrome

Sleep quality in Chinese patients with rheumatoid arthritis: contributing factors and effects on health-related quality of life

Five Balances in the Management of Rheumatoid Arthritis

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