Sleep quality in rheumatoid arthritis: A cross sectional study

Abstract

Introduction

While numerous studies have examined the physical consequences of rheumatoid arthritis (RA), its impact on sleep quality remains relatively understudied.

Objective

This study aims to specifically assess the effect of RA on patients’ sleep quality.

Materials and methods

We conducted a cross-sectional study. Patient characteristics were assessed. The patients’ sleep quality was assessed using the Medical Outcomes Study Sleep Scale (MOS-Sleep scale) in its validated Arabic version.

Results

the study included n = 49 patients with RA. Their mean age was 54.1±12.06 years [24–83]. The mean diagnostic delay was 2.35 years [0.5–13]. The RA was erosive in 46 cases (93.8%), two patients (4.1%) had atlantoaxial subluxation, and coxitis was noted in four cases (8.2%). A longer diagnostic delay was associated with a higher sleep problem index score. A significant positive association was found between VAS pain and all sleep disturbance scores (p = 0.00 and r = 0.518). The presence of comorbidities was associated with a higher index (p = 0.03). This was also true in case of coxitis and/or atlantoaxial subluxation (p = 0.03). For therapeutic management, we did not find a statistically significant association between the use of NSAIDs or corticosteroids, or methotrexate (MTX), and the sleep problem index. However, weekly dosage of MTX was positively correlated with the sleep problem index (p = 0.03, r = 0.358). The multivariate analysis found global patient assessment (GPA) (p = 0.000), presence of comorbidities (p = 0.007), and presence of atlantoaxial subluxation and/or coxitis (p = 0.05) were significant factors influencing sleep quality.

Conclusion

diagnostic delay and the global management of RA patients, including co-morbidities could impact sleep quality. Therefore, early treatment and holistic management of patients are necessary.