scholarly journals A cross-sectional study of sleep and depression in a rheumatoid arthritis population

Author(s):  
Mark Hughes ◽  
Alan Chalk ◽  
Poonam Sharma ◽  
Sandeep Dahiya ◽  
James Galloway

Abstract Objectives To assess the prevalence of impaired sleep quality and depression in a rheumatoid arthritis population and determine their correlation with Disease Activity Score (DAS) and its components. Methods In this single-centre observational cross-sectional study, data was collected by the assessing clinician for DAS28, age and gender in various treatment groups according to use of csDMARDs, biologics and long-term steroids. Presence of impaired sleep quality and depression was assessed by the Pittsburgh Sleep Quality Index (PSQI) and Public Health Questionnaire 9 (PHQ 9). Correlation for DAS and its components with the outcomes was determined by Pearson’s correlation coefficient. Multivariate analysis was performed by logistic regression. Results Two hundred patients were included. The prevalence across all subgroups of poor sleep quality and depression were 86.5% and 30%, respectively, with a correlation coefficient of 0.69 between the two and poor sleep quality amongst all RA patients with comorbid depression. Multivariate analysis found only subjective DAS components, tender joint count (TJC) and patient global health visual analogue score (VAS) to significantly correlate with both outcomes. Age inversely correlated with depression. Long-term steroid use was associated with poorer sleep quality, but there was no significant effect of csDMARDs or biologics. There was no significant difference in prevalence of depression amongst treatment subgroups. Conclusion Poor sleep quality and to a lesser extent depression are prevalent in the general rheumatoid arthritis population. Patients would benefit from clinicians measuring these outcomes routinely as they constitute a significant non-inflammatory burden of living with rheumatoid disease. Key Points• Subjective components of DAS independently correlate with sleep quality and depression, while objective components do not.• Poor sleep quality is highly prevalent in RA and present in all those with comorbid depression.• Poor sleep quality and depression incidence in RA are much lower when DAS is low or remission.

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A148-A148
Author(s):  
S Hong

Abstract Introduction Poor sleep quality is associated with adverse health outcomes, such as cardiovascular disease, diabetes and obesity. Several studies have indicated the association between exposure to air pollution and sleep quality. However, the evidence is very limited in South Korea. Methods We conducted a cross-sectional study using data from a nationwide sample of 165,193 individuals aged 19 years or older from the 2018 Korea Community Health Survey. Perceived air pollution was measured in the baseline survey. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined by the global score of PSQI > 5. The associations between perceived air pollution and sleep quality were examined using the regression models. Additionally, the average concentration of PM2.5 was measured in each region using a satellite-based prediction to see the association between perceived air pollution and long term exposure of fine dust. Results After adjusted for age, education, and income, the adjusted odds ratios (95% confidence interval) of poor sleep quality associated with perceived air pollution was 1.45. The average of daily concentrations of PM2.5 over 3 years was highest in Incheon area, followed by Seoul and Busan city. Among Gyeonggi Province, the most populous region in South Korea, the PM2.5 concentrations was the highest in Ansan. In each region in Korea, Incheon had the highest poor sleep quality rate of 48.0%, while Ansan in Gyeonggi Province had the highest rate of 61.5%. The results are in line with the distribution of PM2.5 concentrations by region. Conclusion Perceived air pollution and long term exposure of fine dust were associated with poor sleep quality in South Korea. Improvement of air quality may help to improve sleep quality. More studies are in need in the future to explore the biological mechanism for the relationship, and to also examine such relationship among different populations and in difference environments. Support For this study, we used raw data from the 2018 Korea Community Health Survey (KCHS), conducted by the Korea Centers for Disease Control and Prevention


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyan Wang ◽  
Xiaoling Dai ◽  
Zichuan Yao ◽  
Xianqing Zhu ◽  
Yunzhong Jiang ◽  
...  

Abstract Introduction To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic. Methods This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression. Results Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384–1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805–0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286–0.920). Conclusions This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1017.2-1018
Author(s):  
N. Kelly ◽  
E. Hawkins ◽  
H. O’leary ◽  
K. Quinn ◽  
G. Murphy ◽  
...  

Background:Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory condition that affects 0.5% of the adult population worldwide (1). Sedentary behavior (SB) is any waking behavior characterized by an energy expenditure of ≤1.5 METs (metabolic equivalent) and a sitting or reclining posture, e.g. computer use (2) and has a negative impact on health in the RA population (3). Sleep is an important health behavior, but sleep quality is an issue for people living with RA (4, 5). Poor sleep quality is associated with low levels of physical activity in RA (4) however the association between SB and sleep in people who have RA has not been examined previously.Objectives:The aim of this study was to investigate the relationship between SB and sleep in people who have RA.Methods:A cross-sectional study was conducted. Patients were recruited from rheumatology clinics in a large acute public hospital serving a mix of urban and rural populations. Inclusion criteria were diagnosis of RA by a rheumatologist according to the American College of Rheumatology criteria age ≥ 18 and ≤ 80 years; ability to mobilize independently or aided by a stick; and to understand written and spoken English. Demographic data on age, gender, disease duration and medication were recorded. Pain and fatigue were measured by the Visual Analogue Scale (VAS), anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), and sleep quality was assessed using the Pittsburgh Sleep Quality Index. SB was measured using the ActivPAL4™ activity monitor, over a 7-day wear period. Descriptive statistics were calculated to describe participant characteristics. Relationships between clinical characteristics and SB were examined using Pearson’s correlation coefficients and regression analyses.Results:N=76 participants enrolled in the study with valid data provided by N=72 participants. Mean age of participants was 61.5years (SD10.6) and the majority 63% (n = 47) were female. Participant mean disease duration was 17.8years (SD10.9). Mean SB time was 533.7 (SD100.1) minutes (8.9 hours per day/59.9% of waking hours). Mean sleep quality score was 7.2 (SD5.0) (Table 1). Correlation analysis and regression analysis found no significant correlation between sleep quality and SB variables. Regression analysis demonstrated positive statistical associations for SB time and body mass index (p-value=0.03846, R2 = 0.05143), SB time and pain VAS (p-value=0.009261, R2 = 0.07987), SB time and HADS (p-value = 0.009721, R2 = 0.08097) and SB time and HADSD (p-value = 0.01932, R2 = 0.0643).Conclusion:We found high levels of sedentary behavior and poor sleep quality in people who have RA, however no statistically significant relationship was found in this study. Future research should further explore the complex associations between sedentary behavior and sleep quality in people who have RA.References:[1]Carmona L, et al. Rheumatoid arthritis. Best Pract Res Clin Rheumatol 2010;24:733–745.[2]Anon. Letter to the editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab = Physiol Appl Nutr Metab 2012;37:540–542.[3]Fenton, S.A.M. et al. Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity. BMC Musculoskelet Disord 18, 131 (2017).[4]McKenna S, et al. Sleep and physical activity: a cross-sectional objective profile of people with rheumatoid arthritis. Rheumatol Int. 2018 May;38(5):845-853.[5]Grabovac, I., et al. 2018. Sleep quality in patients with rheumatoid arthritis and associations with pain, disability, disease duration, and activity. Journal of clinical medicine, 7(10)336.Table 1.Sleep quality in people who have RASleep variableBed Time N(%) before 10pm13(18%) 10pm-12pm43 (60%) after 12pm16 (22%)Hours Sleep mean(SD)6.56 (1.54)Fall Asleep minutes mean(SD)33.3(27.7)Night Waking N(%)45(63%)Self-Rate Sleep mean(SD)2.74 (0.90)Hours Sleep mean(SD)6.56 (1.54)Disclosure of Interests:None declared


2018 ◽  
Vol 10 (11) ◽  
pp. 3918 ◽  
Author(s):  
Lovro Štefan ◽  
Vlatko Vučetić ◽  
Goran Vrgoč ◽  
Goran Sporiš

The main purpose of the present study was to explore the associations of sleep duration and sleep quality with self-rated health. In this cross-sectional study, participants were 894 elderly individuals. Self-rated health, sleep duration, and sleep quality were self-reported. The associations were examined using multiple logistic regression analyses.After adjusting for sex, physical activity, smoking consumption, alcohol consumption, psychological distress, socioeconomic status, and chronic disease/s, sleeping <6 h (OR (Odds ratio) = 3.21; 95% CI (95 percent confident interval) 1.61 to 6.39), 6–7 h (OR = 2.47; 95% CI 1.40 to 4.36), 8–9 h (OR = 3.26; 95% CI 1.82 to 5.83), and >9 h (OR = 3.62; 95% CI 1.57 to 8.34) and having ‘poor’ sleep quality (≥5 points; OR = 2.33; 95% CI 1.46 to 3.73) were associated with ‘poor’ self-rated health. When sleep duration and sleep quality were entered simultaneously into the model, the same associations remained. Our findings provide evidence that both ‘short’ and ‘long’ sleep and ‘poor’ sleep quality are associated with ‘poor’ self-rated health. Thus, interventions that promote healthy sleep hygiene in the elderly are warranted.


2021 ◽  
pp. 074823372110331
Author(s):  
Rehab Shehata Abdelhady Shehata ◽  
Zeinab Ahmed Mohamed Nour ◽  
Amul Mohamed Abdelrahim Badr ◽  
Eman Mahmoud Khalifa

Sleep disorders are prevalent occupational health problems among shift workers, especially healthcare workers with long shifts. Serotonin is a neurotransmitter related to circadian variations accompanied by shift work. A cross-sectional study was performed on 73 nurses at a tertiary hospital in Cairo, Egypt, to assess sleep quality among shift work nurses (SWNs), to determine blood serotonin level, and its relation to shift work and sleep quality. A demographic and occupational history questionnaire, Pittsburgh Sleep Quality Index (PSQI) questionnaire, and measurement of blood serotonin were carried out to the studied group. The data were analyzed using SPSS 25, and descriptive statistics, unpaired t-test, ANOVA, Kruskal–Wallis Test, Chi-square, Spearman correlation, and multivariate regression analysis were utilized. The results showed that the mean PSQI global score was significantly higher among SWNs than non-shift work nurses (NSWNs) and was the highest (10.32 ± 3.56 and 10.22 ± 2.4, respectively) among rotatory and fixed night shift nurses. Blood serotonin showed highly significant differences between SWNs over NSWNs ( p = 0.001), and mostly reduced among rotatory and fixed night shift nurses (66.7% and 65%, respectively). Moreover, there were highly significant differences in serotonin levels between poor and good sleep quality nurses ( p < 0.001), and most of the poor sleep quality nurses (62.7%) had low serotonin levels. Abnormal serotonin level (odds = 246.5) and working years (odds = 1.2) were statistically significant predictors of poor sleep quality. In conclusion, SWNs, especially rotating and night shift nurses, suffer from poor sleep quality associated with abnormal levels of blood serotonin.


2015 ◽  
Vol 49 (4) ◽  
pp. 0596-0602 ◽  
Author(s):  
Juliét Silveira Hanus ◽  
Graziela Amboni ◽  
Maria Inês da Rosa ◽  
Luciane Bisognin Ceretta ◽  
Lisiane Tuon

OBJECTIVEAnalyzing the quality of sleep of hypertensive patients registered in the national registration system and monitoring of hypertensive patients.METHODSA cross-sectional study of quantitative and descriptive analyses with 280 hypertensive patients registered in the National Program of Hypertension and Diabetes of the Federal Government in the months from August to October 2011. Questionnaires were used which allowed for tracking sociodemographic data on hypertension and Pittsburgh Sleep Quality Index (PSQI).RESULTSThe prevalence of poor sleep quality among respondents (156 hypertensive patients) and high rates of using medication for sleeping (106 hypertensive patients) was observed. Other relevant data refers to the quality of sleep among hypertensive patients using sleep medication compared to those who do not use it (p≤0.01).CONCLUSIONIndividuals with high blood pressure have a negative association with sleep quality.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Kemeriya Adem ◽  
Tilahun Kassew ◽  
Addis Birhanu ◽  
Ayalew Abate

Background. Sleep is an active cyclic biological phenomenon and necessary for survival. Individuals who suffer from sleep disturbance are less productive, decreased performance, and negative effects on mental health. Despite there are different studies on sleep quality in Ethiopia, no studies have been conducted on magnitude and predictors of sleep quality among people with epilepsy in the study setting. Objective. To assess sleep quality and associated factors among people with epilepsy who have a follow-up at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019. Method. An institution-based cross-sectional study was employed from May-June 2019. Systematic random sampling following face to face interview technique was employed. Epi-data version 3.1 and SPSS version 25 statistical packages were used for data entry and analysis, respectively. Frequencies, proportions, means, SDs, and cross-tabulations were used to summarize descriptive statistics of the data and tables, texts, and graphs were used for data presentation. To identify association and significant predictor with the outcome variable, binary logistic regression was fitted. The variable which has statistical significance was identified on the basis of p values ≤ 0.05 and AOR with 95% confident intervals. Results. A total of 423 participants have been enrolled to the study with a response rate of 98.1%. The prevalence of poor sleep quality among peoples live with epilepsy was found 65.4% (95% CI: 61.0, 69.9). Being female (AOR=2.94; (95% CI; 1.79, 4.85)), having stress full life events (AOR=2.38; (95% CI; 1.43, 3.97)), nonadherent to AED medication (AOR=1.86; (95% CI; 1.05, 2.78), poly-therapy treatment (AOR=2.24; (95% CI; 1.05, 2.78)), poor seizer control (AOR=2.4; (95% CI; 2.21, 12.46)), comorbid medical illness (AOR=2.6; (95% CI; 1.18, 5.61)), and anxiety (AOR=2.54; (95% CI; 1.52,4.24)) were factors significantly associated with poor sleep quality. Conclusion. This study revealed that more than half of the study participants were found to have poor sleep quality. So, considering the regular assessment of sleep quality and factors associated followed with appropriate intervention is recommended among peoples living with epilepsy.


2021 ◽  
Vol 5 (2) ◽  
pp. 65-72
Author(s):  
Siti Roziah Ria Famuji ◽  
Abdul Malik Setiawan ◽  
Achdiat Agoes

Hypertension affects approximately 26% of the adult population and it is a leading cause of death in up to 13.5% worldwide. Hypertension is a disease with the highest prevalence in Indonesia, so good treatment and prevention are needed. Several studies suggest that there is a correlation between hypertension risk factors and the disturbance of sleep quality. Therefore, it is necessary to develop preventive and promotive efforts to obtain optimum blood pressure in patients with hypertension to avoid complications or even death. This study aims to find out the correlation between sleep quality and the value of blood pressure in the elderly ?60 years old in Batu City. A cross-sectional study was conducted in Batu City in 2020. Stratified random sampling was performed to select the respondents. A validated PSQI questionnaire and sphygmomanometer were used to assess sleep quality and blood pressure, respectively. A Chi-Square test was used to test the hypothesis. There were 391 respondents involved in this study. Most of the respondents have poor sleep quality, 205 respondents (52,43%) of which 41 respondents (20%) have normal blood pressure, and 164 respondents (80%) have high blood pressure. The statistical analysis shows a significant correlation (p=0,000) between sleep quality and blood pressure. In conclusion, hypertension is associated with poor sleep quality in the geriatric population in Batu City.


2018 ◽  
Vol 11 (1) ◽  
pp. 369-375 ◽  
Author(s):  
Sofa D. Alfian ◽  
Henry Ng ◽  
Dika P. Destiani ◽  
Rizky Abdulah

Introduction: Poor subjective sleep quality in undergraduate students has not been widely studied in Bandung city, Indonesia. Poor sleep quality has been related to a number of risk factors for poor health outcomes. Objective: To analyze the association between psychological distress and subjective sleep quality. Methods: A cross sectional survey was done in one of the universities of Bandung city, Indonesia. Data were collected from 290 undergraduate students selected through consecutive sampling. Pittsburg Sleep Quality Index (PSQI) and Kessler-10 questionnaire were administered. Results: The prevalence of psychological distress was well (43.1%), mild (28.6%), moderate (20.7%), and severe (7.6%). The overall sleep quality was poor and good in 84.5% and 15.5% of the students. There was a significant association between psychological distress and poor sleep quality (p=0.006). The multivariate analysis suggested that psychological distress was a predictor of poor sleep quality (OR 1.991; 95% CI, 1.311−3.026). Conclusion: There is a need for an awareness of the college resources to help manage the stress levels of students through effective coping strategy-related study habits.


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