Korean J Intern Med.  2015 May;30(3):384-390. 10.3904/kjim.2015.30.3.384.

Sleep quality in rheumatoid arthritis, and its association with disease activity in a Korean population

• Son CN
• Choi G
• Lee SY
• Lee JM
• Lee TH
• Jeong HJ
• Jung CG
• Kim JM
• Cho YW
• Kim SH

• KMID: 2160711
• DOI: http://doi.org/10.3904/kjim.2015.30.3.384

Abstract

BACKGROUND/AIMS
The aim of this study was to compare the sleep quality between rheumatoid arthritis (RA) patients and healthy controls; and to evaluate the relationship between RA disease activity and sleep quality in Korea.
METHODS
A total of 130 RA patients and 67 age- and sex-matched healthy controls were enrolled in a comparative study of sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Age, gender, concomitant medication, erythrocyte sedimentation rate, serum C-reactive protein, Beck Depression Inventory second edition (BDI-II), 28 joints disease activity score (DAS28), pain visual analog scale (VAS), and PSQI were analyzed as covariates. We also analyzed the sleep quality of RA patients according to the disease activity (DAS28 < or = 3.2, 3.2 < DAS28 < 5.1, and DAS28 > or = 5.1, respectively).
RESULTS
The total PSQI score and the frequency of poor sleep quality, were higher in the RA patients (5.62 +/- 4.19, 38.5%) than in the control subjects (3.57 +/- 2.17, 13.4%). The patients with poor sleep quality (PSQI > 5) were older and had a higher BDI-II and VAS score than the patients without sleep disturbance (PSQI < or = 5). The score in subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, daytime dysfunction, total PSQI, and frequency of poor sleep quality were increased when RA activity was high.
CONCLUSIONS
Sleep disturbance was observed in RA patients (38.5%), and high RA disease activity was associated with poor sleep quality in Korea.

Keyword

Rheumatoid arthritis; Sleep quality; Disease activity; Depression

MeSH Terms

Adult
Aged
Aged, 80 and over
Arthritis, Rheumatoid/diagnosis/ethnology/*physiopathology
Asian Continental Ancestry Group
Case-Control Studies
Cross-Sectional Studies
Depression/diagnosis/ethnology
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Republic of Korea/epidemiology
Risk Factors
Severity of Illness Index
*Sleep
Sleep Wake Disorders/diagnosis/ethnology/*physiopathology
Surveys and Questionnaires
Young Adult