J Rheum Dis.  2023 Apr;30(2):99-105. 10.4078/jrd.22.0053.

The effect of disease-modifying antirheumatic drugs on sleep and quality of life in older patients with rheumatoid arthritis

  • 1Department of Rheumatology, Faculty of Medicine, Aydin Adnan Menderes University, Aydın, Turkey


The sleep quality is worse in rheumatoid arthritis (RA) patients than in healthy controls and it is more difficult to achieve a satisfactory quality of life after treatment with age. Our aim is to assess the quality of life and sleep in elderly onset RA patients and to analyze the effect of disease-modifying agents on sleep and quality of life.
Thirty-four older patients with RA patients and 30 healthy controls are included in the study. Sleep quality was evaluated with the Pittsburg sleep quality index and quality of life with Short Form-36. Parametric/non-parametric tests and Spearman/ Pearson correlation analysis were applied for the data according to the distribution.
While the rate of poor sleep quality before treatment was 67.6%, the rate was 26.5% after treatment. There was a statistically significant difference before and after treatment in terms of subjective sleep quality, sleep latency, sleep duration, sleep efficiency, and scores for sleep disturbance. The mean steroid dose and Disease Activity Score-28 were higher in patients with poor sleep quality than in patients with good sleep quality. Patients with poor sleep quality had lower mean physical function, pain, general health, social function, emotional role difficulties, and energy/vitality values than patients with good sleep quality.
Both sleep and quality of life improved after treatment in older patients with RA patients. In older patients, it should be regularly evaluated in terms of sleep and quality of life and appropriate treatment should be provided.


Rheumatoid arthritis; Aging; Sleep quality; Quality of life


  • Fig. 1 Distribution of scores according to Pittsburgh Sleep Quality Index of patients with rheumatoid arthritis before and after treatment. Wilcoxon signed-rank test; *p<0.01.

  • Fig. 2 Distribution of scores according to quality of life evaluated with SF-36 (Short Form-36) in patients with rheumatoid arthritis before and after treatment. Paired-samples t-test; *p<0.05.


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