Rheumatoid arthritis and sleep quality

Background

Sleep disturbances are common in rheumatoid arthritis (RA) patients and contribute to loss of life quality.

Objective

To study associations of sleep quality with pain, depression and disease activity in RA.

Methods

This is a transversal observational study of 112 RA patients submitted to measurement of DAS-28, Epworth scale for daily sleepiness, index of sleep quality by Pittsburg index, risk of sleep apnea by the Berlin questionnaire and degree of depression by the CES-D (Center for Epidemiologic Studies Depression scale) questionnaire. We also collected epidemiological, clinical, serological and treatment data.

Results

Only 18.5% of RA patients had sleep of good quality. In univariate analysis a bad sleep measured by Pittsburg index was associated with daily doses of prednisone (p = 0.03), DAS-28 (p = 0.01), CES-D (p = 0.0005) and showed a tendency to be associated with Berlin sleep apnea questionnaire (p = 0.06). In multivariate analysis only depression (p = 0.008) and Berlin sleep apnea questionnaire (p = 0.004) kept this association.

Conclusions

Most of RA patients do not have a good sleep quality. Depression and risk of sleep apnea are independently associated with sleep impairment.