Bath Ankylosing Spondylitis Disease Activity Index is Associated With the Quality of Sleep in Ankylosing Spondylitis Patients

Abstract

Objective. High disease activity of ankylosing spondylitis (AS) is associated with poor sleep quality. The purpose of this study was to identify which of the representative tools for evaluating the disease activity of AS best reflect the quality of sleep. Methods. A total of 107 AS patients were enrolled in the study and the sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Age, sex, concomitant medication, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) level, Beck Depression Inventory second edition (BDI-II), Bath ankylosing spondylitis disease activity index (BASDAI), ankylosing spondylitis disease activity score (ASDAS)-ESR, ASDAS-CRP, pain visual analog scale, Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) were analyzed as covariates. Results. Overall, 65% (70/107) of subjects reported poor sleep quality (PSQI＞5). There was a positive correlation between the sleep quality and disease activity as measured by the BASDAI, ASDAS-ESR, and ASDAS-CRP. In addition, the BASDAI demonstrated good correlations with ISI, ESS, and BDI-II, respectively. However, only BASDAI showed reliable correlation with PSQI among the disease activity parameters of AS (adjusted odd ratio 5.36, p=0.023). Conclusion. BASDAI is the most reliable parameter of disease activity associated with the sleep quality in patients with AS.

Cut-Offs for Disease Activity States in Axial Spondyloarthritis With Ankylosing Spondylitis Disease Activity Score (ASDAS) Based on C-Reactive Protein and ASDAS Based on Erythrocyte Sedimentation Rate: Are They Interchangeable?

“…Our cohort revealed higher mean ASDAS-CRP than mean ASDAS-ESR at both baseline and followup, which is consistent with a previous smaller study (12), although other studies have demonstrated lower ASDAS-CRP than ASDAS-ESR (9)(10)(11). In previous studies, the absolute difference between mean ASDAS-CRP and mean ASDAS-ESR ranged from zero (6)(7)(8) to one unit or above(9,10), while we found corresponding differences close to zero.…”

“…However, ASDAS-ESR showed a trend to classify higher numbers of patients in lower disease activity states compared to ASDAS-CRP and lower numbers of patients in higher disease activity states(4). Thereafter, some studies have reported equal mean ASDAS scores(6-8), whereas others have observed differences (9)(10)(11)(12). Hence, there may be clinically relevant discrepancies between the two versions and consequently between their cut-off values for disease activity states, which could impact on treatment decisions in a treat-to-target regimen.…”

Prevalence of sleep disturbance in patients with ankylosing spondylitis: a systematic review and meta-analysis

“…1). The information from 18 studies is outlined in Table 1 [6,10,14,16,19,20,22,27,28,[34][35][36][37][38][39][40][41][42].…”

The effect of disease-modifying antirheumatic drugs on sleep and quality of life in older patients with rheumatoid arthritis

“…High disease activity of ankylosing spondylitis is associated with poor sleep quality. A positive correlation was reported between the ankylosing spondylitis disease activity indices Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score with ESR, Ankylosing Spondylitis Disease Activity Score with CRP and sleep quality [17]. Pittsburgh Sleep Quality Index was developed in 1989 by Buysse et al [15] and Turkish validity and reliability study was performed by Ağargün et al [18].…”