The Effect of Neuropathic Pain on Sleep Quality in Patients with Axial Spondyloarthritis

Abstract

Objective: This study aims to determine whether neuropathic pain (NP) presence affects sleep quality in patients with axial spondyloarthritis (AxSpA). Materials and Methods: Demographic data of the patients were documented. The patient's NP was evaluated with painDETECT questionnaire. Pittsburgh Sleep Quality Index (PSQI), Ankylosing Spondylitis Quality of Life (AsQoL), Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP), and visual analog scale (VAS) were used to evaluate sleep quality, quality of life (QoL), pain severity and disease activity, respectively. Results: Among the 108 patients who participated in the researh, 51 were female and 57 were male. NP was found in 41.7% of them. 65.7% Of all patients had a sleep disorder. AxSpA patients with NP had a statistically significant higher VAS-activity, VAS-night, and VAS-rest scores (p<0.001, p<0.001, p=0.002, respectively). They also had higher ASQoL scores and higher disease activity. (p=0.008, p=0.012, respectively). Although impaired sleep was detected in 71.1% of AxSpA patients with NP, it was present in 61.9% of AxSpA patients without NP, and we didn’t find a statistically significant difference (p=0.32). Total painDETECT scores were correlated with PSQI ASQoL, and VAS scores (p< 0.001). But there was no correlation with ASDAS-CRP scores (p=0.57). Conclusion: A large majority of AxSpA patients have a sleep problem, independent of the presence of NP. Not only targeting the inflammatory pain but also targeting NP and sleep disorder together in the follow-up of patients with AxSpA will improve QoL.