Association of the sleep quality with pain, radiological damage, functional status and depressive symptoms in patients with knee osteoarthritis

Abstract

Objective: The aim of this study is to evaluate the sleep quality and relationship between the sleep quality with disease-related variables, pain, functional status, radiological damage and the psychological status in patients with Osteoarthritis (OA). Methods:Fifty two patients diagnosed with OA and 35 healthy control subjects were enrolled in the study. The demographic characteristics of the patients such as age, education level, and marital status were recorded. Disease related disability were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Generalized pain, generalized fatigue and knee pain were assessed with the Visual Analogue Scale (VAS). Psychological status were evaluated with the Hospital Anxiety Depression Scale. The radiological grade of knee OA was evaluated according to the Kellgren Lawrence score. For the evaluation of the sleep quality, the OA and control groups were assessed with the help of the Pittsburgh Sleep Quality Index (PSQI). Results:The patients with OA had significantly higher scores in the subjective sleep quality, sleep latency, habitual sleep efficiency and total PSQI score compared to the healthy control group (p<0.05). According to the results of Spearman's analysis, there was a significantly correlation between the total PSQI score with age, generalized pain, knee pain, WOMAC pain, radiological damage and depressive symptoms (p<0.05). Conclusions:The sleep quality is disturbed in patients with OA. Lower quality of sleep is especially associated with the pain, radiological damage and depressive symptoms. J Clin Exp Invest 2013; 4 (2): 189-194Key words: Knee osteoarthritis, sleep quality, pain, radiological grade, depression ÖZET Amaç: Bu çalışmanın amacı diz osteoartriti (OA) tanılı hastalarda uyku kalitesini değerlendirmek ve uyku kalitesi ile klinik parametreler, ağrı, fonksiyonel durum, radyolojik hasar ve psikolojik durum arasındaki ilişkiyi incelemektir.Yöntemler: Diz osteoartriti tanılı 52 hasta ve 35 sağlık-lı gönüllü çalışmaya dahil edildi. Hastaların yaş, eğitim seviyesi, medeni durumu gibi demografik özellikleri kaydedildi. Hastalıkla ilişkili yeti yitimi, Western Ontario ve McMaster Üniversitesi Osteoartrit indeksi (WOMAC) ile değerlendirildi. Genel ağrı, genel yorgunluk ve diz ağrısı seviyesi görsel analog skala ile değerlendirildi. Psikolojik durum hastane anksiyete depresyon skalası ile ölçüldü. Diz osteoartritinin radyolojik evresi Kellgren Lawrence skoruna göre hesaplandı. Hasta ve kontrol grubunun uyku kalitesi, Pittsburgh uyku kalitesi indeksi (PUKİ) yardımıyla değerlendirildi.Bulgular: Diz osteoartriti olan hastalarda, öznel uyku kalitesi, uykuya dalma süresi, alışılmış uyku etkinliği ve total PUKİ skoru kontrol grubuna göre anlamlı olarak yüksekti (p<0,05). Spearman analizi sonuçlarına göre, total PUKİ skoru ile yaş, yaygın ağrı, diz ağrısı, WOMAC ağrı, radyolojik evre ve depresif semptomlar arasında anlamlı korelasyonlar saptandı (p<0,05).Sonuç: Diz OA tanılı hastalarda uyku kalitesi bozulmaktadır. Bozulmuş uy...

The effect of physical therapy and rehabilitation modalities on sleep quality in patients with primary knee osteoarthritis: A single-blind, prospective, randomized-controlled study

“…Wilcox et al [27] included 429 knee OA patients and reported problems with sleep onset (31%), sleep maintenance (81%), and early morning awakenings (51%) occurred at least weekly. Sariyildiz et al [28] also included 52 knee OA patients and found significantly higher subjective sleep quality, falling asleep period, and usual sleep habit, and total PSQI scores in the patient group compared to the controls. In our study, consistent with these findings, we also observed that both groups had significantly worse sleep quality using the PQSI scale.…”

Fatigue in individuals with knee osteoarthritis: Its relationship with sleep quality, pain and depression

“…Sleeplessness is a risk factor for fatigue in OA 5,8. The problem of sleeplessness can occur in most of the rheumatic diseases, and its main cause is pain 9. Pain that increases with activity and decreases at rest in the early stage of the disease becomes more intense and resistant as the disease progresses.…”

“…Studies have shown that arthritis affects sleep quality adversely. These studies have also shown that patients with arthritis have sleeping problems such as difficulty in falling asleep, frequent sleep disruption and early morning awakening 9,11,12. The literature review indicates that although the majority of studies have been conducted on sleep quality in patients with rheumatoid arthritis, the number of studies investigating sleep quality in patients with KOA is low 9.…”

“…The literature review indicates that although the majority of studies have been conducted on sleep quality in patients with rheumatoid arthritis, the number of studies investigating sleep quality in patients with KOA is low 9. It is pointed out that pain, joint stiffness, functional limitation, sleeplessness and fatigue can affect each other,2,8,9 which may have negative effects on the psychological wellbeing and that one of these negative effects is depression 5…”

“…When fatigue is studied in this respect, it is also important to determine the relationship between fatigue and depression. It is stated that there may be a many-sided interaction between clinical and psychological symptoms such as insomnia,9 fatigue5 and pain3 experienced by individuals with OA 8,9. Fatigue in OA has been reported to be related with physical and psychological factors, but what this relationship stems from is not clear, and studies relevant to this issue are very few4,14 However, in order to successfully manage fatigue, which has been shown to be the most distressing condition in the management of chronic diseases, it is important to determine these interactions 2,4.…”