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

Abstract

To investigate fatigue, health-related quality of life (HR-QOL), and sleep quality in women with primary Sjogren syndrome (pSS) or rheumatoid arthritis (RA) as compared with healthy controls using self-reports and wrist actigraphy. In this cross-sectional observational study, we evaluated a total of 25 patients (aged 40–75 years) with pSS, 10 with RA, and 17 healthy control subjects living in Japan. The HR-QOL was assessed using the Short Form-36. Fatigue was evaluated using the Short Form-36 vitality score, visual analog scale (VAS) for fatigue, and 2 questionnaire items using scores based on a 4-point Likert scale. Sleep quality was measured using the Japanese version of the Pittsburgh Sleep Quality Index, VAS for sleep quality, and wrist actigraphy for 14 days. Patients with pSS reported severer fatigue and lower HR-QOL than healthy controls, especially in mental health. Based on the Pittsburgh Sleep Quality Index score, 56% of the patients with pSS were poor sleepers, which was higher than healthy controls (29.4%). Furthermore, the patients with pSS scored significantly lower on the VAS for sleep quality than healthy controls (40.5 vs 63.7, P = .001). Although subjective assessments revealed slight sleep disturbances in patients with pSS, wrist actigraphy revealed no differences when compared with healthy controls for total sleep time (421.8 minutes vs 426.5 minutes), sleep efficiency (95.2% vs 96.4%), number of awakenings (1.4 vs 0.9), and wake after sleep onset (22.4 minutes vs 16.1 minutes). Poor subjective sleep quality was associated with enhanced fatigue. However, sleep efficiency, as determined by actigraphy, was not associated with fatigue. Notably, the patients with RA and healthy controls did not differ significantly in terms of fatigue or sleep quality, although patients with RA experienced more nocturnal awakenings than healthy controls (1.7 vs 0.9, P = .04). Patients with pSS experience severe fatigue, poor HR-QOL, and sleep disturbances, which are associated with fatigue. However, wrist actigraphy did not reveal differences in sleep quality, suggesting that it may not be an appropriate measure of sleep in patients with pSS.

The Relationship Between Sjogren’s Syndrome and Sleep Disturbance: A Case Report

“…Cognitive issues did not show as pathologic brain MRIs [ 7 ]. There was a cross-sectional study that compared people with rheumatoid arthritis and Sjogren’s syndrome to healthy controls [ 9 ]. Patients with Sjogren’s syndrome had significantly lower quality of life scores than healthy controls, but there were no significant differences in the physical component of the scoring of QoL [ 9 ].…”

“…Patients with Sjogren’s syndrome had significantly lower quality of life scores than healthy controls, but there were no significant differences in the physical component of the scoring of QoL [ 9 ]. People with RA had lower physical component scores [ 9 ]. Patients with Sjogren’s syndrome also had a significantly higher amount of fatigue than controls, while people with RA did not differ in terms of fatigue [ 9 ].…”

“…People with RA had lower physical component scores [ 9 ]. Patients with Sjogren’s syndrome also had a significantly higher amount of fatigue than controls, while people with RA did not differ in terms of fatigue [ 9 ]. People with Sjogren’s syndrome had poor sleep compared to control, and they were not as refreshed on awakening [ 9 ].…”

“…Patients with Sjogren’s syndrome also had a significantly higher amount of fatigue than controls, while people with RA did not differ in terms of fatigue [ 9 ]. People with Sjogren’s syndrome had poor sleep compared to control, and they were not as refreshed on awakening [ 9 ]. There was no significant difference between the RA and control group in terms of sleep quality [ 9 ].…”

“…People with Sjogren’s syndrome had poor sleep compared to control, and they were not as refreshed on awakening [ 9 ]. There was no significant difference between the RA and control group in terms of sleep quality [ 9 ]. However, wrist actigraphy was used as a method of measuring sleep quality [ 9 ].…”