Rheumatoid arthritis and sleep quality

Abstract

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.

Keywords: Apneia do sono; Artrite reumatoide; Depression; Depressão; Dor; Pain; Rheumatoid arthritis; Sleep; Sleep apnea; Sono.