The assessment of fatigue and sleep quality among children and adolescents with familial Mediterranean fever: A case-control and correlation study

Abstract

To evaluate the sleep quality and fatigue levels in children with familial Mediterranean fever (FMF) in comparison to healthy children. The Pediatric Quality of Life Multidimensional Fatigue Scale (PedsQL-MFS) and the Pittsburgh Sleep Quality Index (PSQI) were the instruments utilized to assess fatigue and sleep quality in children with FMF and controls, respectively. Spearman’s rank coefficient was decisive in determining the association between patient-reported outcome measures and disease-related features. Two hundred twenty-five (59.3% female) patients and 182 (51.6% female) healthy counterparts were enrolled in the study. In PSQI, where high scores indicate sleep disturbance, the median score was significantly higher in the patient group (5; 3–6) than the control group (3; 2–4) (p < 0.001). PEDsQL-MFS demonstrated significantly lower fatigue levels in the control group than patients (p = 0.01). The level of fatigue in the patient group was found to increase in correlation with sleep problems (r: − 0.750, p < 0.001). Additionally, a high correlation was present between the PSQI/PedsQL-MFS scores and the number of attacks in the last year (r: − 0.645, p < 0.001/r: 0.721, p < 0.001, respectively). There was no difference in terms of fatigue and sleep disorders between mutations (homozygous, heterozygous, or compound heterozygous) in the MEFV gene (p > 0.05). Conclusion: High disease activity has a significant negative impact on the sleep quality and fatigue levels of patients with FMF. This study emphasizes the importance of assessing fatigue and sleep quality with objective outcome tools periodically in FMF patients throughout the disease course. What is Known:• Fatigue is a common matter that often accompanies rheumatic diseases and causes disability.• Chronic rheumatic diseases often experience poor sleep quality. What is New:• In high correlation with the disease severity of familial Mediterranean fever, sleep quality decreases and fatigue level increases significantly.• In familial Mediterranean fever patients, a negative correlation is present between age and the general fatigue and sleep/rest related fatigue scores (low scores indicating greater fatigue) and sleep quality is poorer in the adolescent age group.

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“…PPGA may also capture levels of fatigue, pain, psychological comorbidities, and impaired social participation experienced by the patient and family [55,56]. This highlights the importance of clarity on measuring constructs of disease activity, disease damage, burden of illness, and objective assessment of fatigue/sleep quality [57]. Recently, the Protokolle in der Kinderrheumatologie (PRO-KIND) initiative of the German Society for Pediatric Rheumatology (GKJR) has proposed a new composite tool for FMF [17].…”