Arthritis, Sleep Health, and Systemic Inflammation in Older Men

Abstract

ObjectiveTo examine the associations of prevalent arthritis with systemic inflammation in older men and to test whether sleep health mediates the associations.MethodsCross‐sectional data came from 2,562 community‐dwelling older men (all were age 65 years or older; mean age 76 years) in the Osteoporotic Fractures in Men Study who participated in a sleep ancillary study in 2003–2005. Participants were classified as having osteoarthritis (OA) (24%) or rheumatoid arthritis (RA) (0.7%) based on self‐reported diagnoses and medication use. We constructed a composite score of multidimensional sleep health (i.e., perceived sleep quality, sleepiness, frequency of daytime napping, wake after sleep onset, and sleep duration) measured by both self‐report and actigraphy. We also created binary indicators of elevated inflammation using C‐reactive protein (CRP) (>3 mg/liter) and interleukin‐6 (IL‐6) (>1.08 pg/ml) levels. Analyses controlled for age, diagnosed sleep disorders, body mass index, smoking status, relevant medication use, and comorbidities.ResultsOlder men with OA did not have higher risk of elevated CRP or IL‐6 levels. However, indirect associations of OA through sleep health were found. OA was associated with poorer sleep health, which was further associated with 16% higher odds of elevated CRP (P < 0.001) and 12% higher odds of elevated IL‐6 (P < 0.01) levels after controlling for OA. Older men with RA had higher odds of elevated CRP and IL‐6 levels, but the associations were not mediated by sleep health.ConclusionFindings suggest that promoting sleep health may help reduce the risk of systemic inflammation in older men with OA.

Association of plant‐based diet index with inflammatory markers and sleep quality in overweight and obese female adults: A cross‐sectional study

“…We also found a significant inverse association between hs‐CRP and TGF‐β with sleep quality. This finding was in accordance with the studies examining the association between inflammatory markers and sleep health 14,109,110 . It must be kept in mind that sleep disturbances and inflammation have a bidirectional association.…”

Cross-sectional assessment of sleep and fatigue in middle-aged Japanese women with primary Sjogren syndrome or rheumatoid arthritis using self-reports and wrist actigraphy

“…Although actigraphy revealed a slightly higher number of nocturnal awakenings in the RA patients, consistent with the results of polysomnographic studies, [1] the RA patients did not report worse sleep quality or fatigue. This is consistent with a recent study, which found that RA was not correlated with poor sleep in male patients aged 65 years or older using a sleep health score measured by self-reporting and actigraphy [34] . Furthermore, in RA, sleep disturbances are thought to primarily stem from pain and depression [3] .…”

The existing state of knowledge about sleep health in community-dwelling older persons – a scoping review

“…Seven of the studies [ 12–18 ] measured sleep health using a combination of self-reported or objective sleep instruments to match the sleep health dimension outcome: the Epworth sleepiness scale, self-reported questions following the sleep health dimensions, SOF sleep questionnaires, Pittsburgh Sleep Quality Index (PSQI), or wristwatch actigraphy ( Table 2 ). The outcome for good or poor sleep health was determined in one study as a composite score between 0 and 5, where higher scores represented better sleep health, in another study, higher scores represented poorer sleep health [ 14 ]. Sleep health scores were also calculated by the number of poor or good sleep health dimensions and then classified from 0 to 3 or more, up to 5 [ 12 , 13 , 15 ].…”

“…One study by Lee et al. [ 14 ] reported an association between sleep health and osteoarthritis (OA) or rheumatoid arthritis (RA) among 2,562 community-dwelling older men. The study showed that participants with OA (not RA) had significantly poorer sleep health than those without OA, even after correcting for age, health issues, and medication covariates.…”

“…The study showed that participants with OA (not RA) had significantly poorer sleep health than those without OA, even after correcting for age, health issues, and medication covariates. Moreover, poorer sleep health is significantly associated with a higher risk of elevated C-reactive protein (16% risk) and interleukin 6 levels (12% risk), which are associated with inflammation [ 14 ]. Sleep health among older men, in relation to healthcare costs, showed that men with two to four self-reported poor sleep health domains, had increased healthcare costs ($4,416 to $5,819) over a three-year period, compared to men without impaired sleep health ($3,716).…”