P192 Heartburn in Crohn's disease is associated with increased disease activity, poor sleep quality and prior ileocecectomy

Abstract Background and Aims Poor sleep quality in Crohn’s disease (CD) is associated with histologic activity and clinical relapse. We sought to characterize sleep dysfunction and determine the effect of poor sleep quality on risk for hospitalization and surgery. Methods Clinical data were collected for CD subjects including the Pittsburgh Sleep Quality Index (PSQI) and Harvey-Bradshaw index (HBI). The PSQI score and a brief medical history were obtained for control subjects. The PSQI and HBI correlation was tested at an initial clinic visit and at follow-up. Crohn’s disease subjects with and without poor sleep were compared for risk of hospitalization or surgery by Kaplan–Meier and Cox proportional hazards. Results Ninety-two CD and 82 control subjects were included. Crohn’s disease and control subjects shared similar baseline characteristics and PSQI (8.3 vs 7.8, P = 0.31), and 77% of the CD population had PSQI >5. Crohn’s disease subjects with PSQI >5 more often had inflammatory phenotypes and reported increased benzodiazepine and psychiatric medication use. Crohn’s disease subjects with PSQI >5 also reported more night awakenings due to pain and bathroom use. The PSQI correlated with HBI (r = 0.256, P = 0.014), and ΔPSQI on follow-up correlated with ΔHBI (r = 0.47, P = 0.002). Cox proportional hazards model for hospitalization or surgery showed that PSQI >8 was predictive of surgery or hospitalization (hazards ratio 5.37; 95% confidence interval, 1.39–27.54). Conclusion There is a high burden of poor sleep quality in CD, which is associated with risk for adverse outcomes. Sleep quality may identify CD patients at risk for complications and have prognostic value in CD.

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P207 Poor sleep quality is a risk factor for hospitalisation and surgery in Crohn’s disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjx180.334 ◽

2018 ◽

Vol 12 (supplement_1) ◽

pp. S204-S204 ◽

Cited By ~ 3

Author(s):

M A Sofia ◽

A M Lipowska ◽

E Y Perez ◽

N Zmeter ◽

R T Kavitt ◽

...

Keyword(s):

Risk Factor ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Sleep Quality ◽

Poor Sleep ◽

Poor Sleep Quality

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A Multidimensional Model of Fatigue in Patients with Rheumatoid Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.111068 ◽

2012 ◽

Vol 39 (9) ◽

pp. 1807-1813 ◽

Cited By ~ 27

Author(s):

PERRY M. NICASSIO ◽

SARAH R. ORMSETH ◽

MARA K. CUSTODIO ◽

MICHAEL R. IRWIN ◽

RICHARD OLMSTEAD ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Sleep Quality ◽

Disease Activity ◽

Structural Equation ◽

Mood Disturbance ◽

Equation Modeling ◽

Poor Sleep ◽

Direct Effects ◽

Multidimensional Model ◽

Poor Sleep Quality

Objective.To evaluate a multidimensional model testing disease activity, mood disturbance, and poor sleep quality as determinants of fatigue in patients with rheumatoid arthritis (RA).Method.The data of 106 participants were drawn from baseline of a randomized comparative efficacy trial of psychosocial interventions for RA. Sets of reliable and valid measures were used to represent model constructs. Structural equation modeling was used to test the direct effects of disease activity, mood disturbance, and poor sleep quality on fatigue, as well as the indirect effects of disease activity as mediated by mood disturbance and poor sleep quality.Results.The final model fit the data well, and the specified predictors explained 62% of the variance in fatigue. Higher levels of disease activity, mood disturbance, and poor sleep quality had direct effects on fatigue. Disease activity was indirectly related to fatigue through its effects on mood disturbance, which in turn was related to poor sleep quality. Mood disturbance also indirectly influenced fatigue through poor sleep quality.Conclusion.Our findings confirmed the importance of a multidimensional framework in evaluating the contribution of disease activity, mood disturbance, and sleep quality to fatigue in RA using a structural equation approach. Mood disturbance and poor sleep quality played major roles in explaining fatigue along with patient-reported disease activity.

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Altered sleep quality is associated with Crohn’s disease activity: an actimetry study

Sleep And Breathing ◽

10.1007/s11325-019-01934-z ◽

2019 ◽

Vol 24 (3) ◽

pp. 971-977 ◽

Cited By ~ 3

Author(s):

Thomas Bazin ◽

Jean-Arthur Micoulaud Franchi ◽

Nathalie Terras ◽

Jacques Taillard ◽

David Laharie ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Sleep Quality ◽

Disease Activity ◽

Crohn’S Disease Activity

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POS0159-HPR IMPACT OF SLEEP DISTURBANCES ON ELDERLY PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.408 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 292.1-292

Author(s):

M. Sellami ◽

O. Hamdi ◽

S. Miladi ◽

A. Fazaa ◽

L. Souabni ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Elderly Patients ◽

Sleep Quality ◽

Disease Activity ◽

Functional Status ◽

Sleep Disturbances ◽

Tender Joint Count ◽

Poor Sleep ◽

Poor Sleep Quality ◽

The Mean

Background:Sleep disturbances have been reported in various rheumatic diseases especially in the elderly. It may be caused by pain and depressive mood. However, reports on the impact of sleep problems in rheumatoid arthritis (RA) activity and functional status were limited.Objectives:To assess sleep quality in elderly patients with RA and its impact on disease activity and functional status.Methods:This cross-sectional study included 70 RA patients aged ≥ 65 years fulfilling the ACR/EULAR criteria. Sociodemographic data were collected. RA activity was assessed with the Disease Activity Score (DAS28) and functional status with the Health Assessment Questionnaire (HAQ). Sleep quality was assessed using Arabic translated versions of two indexes: the Insomnia Severity Index (ISI) and the Pittsburg Sleep Quality Index (PSQI). An ISI score of [8-14], [15-21], and [22-28] determined respectively mild, moderate, and severe insomnia. A PSQI score > 5 determined poor sleep quality. ANOVA test was used to assess the relationship between DAS28 erythrocyte sedimentation rate (ESR), HAQ, and sleep quality indexes.Results:This study included 52 females and 18 males with a mean age of 68.3 ± 25 years [65-81]. Seventy percent of patients were married, 27% were widowed and 2% were divorced. Seventy-one percent of patients were illiterate, 18% had primary education and 11% had secondary education. Eighteen percent of patients were employed whereas 34.7% were retired. A history of depression was noted in 16.5% of patients. The mean duration of RA was 17.4 ± 5.2 years. Eighty-five percent of patients were on conventional synthetic DMARD whereas 15% were treated with biologic treatment. The mean patient’s global assessment of disease activity was 5.2 ± 1.3. The mean tender joint count and mean swollen joint count were 8 ±1.5 and 5 ±1 respectively. The mean DAS28 ESR was 4.7 ±0.9. The mean HAQ was 2.4 ± 0.45. Poor sleep quality was detected in 84% of cases according to the PSQI score. Mild insomnia was detected in 46% of cases, moderate insomnia in 34% of cases, and severe insomnia in 12% of cases. RA activity was higher in patients with poor sleep quality: the mean DAS28 ESR was 5.2 in patients with severe insomnia, 4.82 in moderate insomnia, and 4.13 in mild insomnia; p= 0.00 respectively. The mean ESR was 31.5 mm in patients with severe insomnia, 22.1 mm in moderate insomnia, and 10.6 mm in mild insomnia; p= 0.01 respectively. Furthermore, the higher the PSQI was, the higher DAS28 ESR is (p =0.01). However, no association was found between poor sleep quality and joint count, swollen joint count, CRP, and HAQ.Conclusion:Disease activity was a major contributor to poor sleep quality in elderly patients with RA. Functional status however wasn’t associated with insomnia. Physicians should include sleep in the clinical assessment of RA patients to improve their quality of life.Disclosure of Interests:None declared

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P171 Factors determining sleep quality in SLE

Rheumatology ◽

10.1093/rheumatology/keaa111.166 ◽

2020 ◽

Vol 59 (Supplement_2) ◽

Author(s):

Rosalie Magro ◽

Liberato Camilleri ◽

Andrew A Borg

Keyword(s):

Sleep Quality ◽

Disease Activity ◽

Lupus Erythematosus ◽

Functional Disability ◽

Activity Index ◽

Depression Scale ◽

Disease Activity Index ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Cross Sectional

Abstract Background Poor sleep quality is common in systemic lupus erythematosus (SLE) and could contribute to fatigue, which is regarded as one of the most disabling symptoms in SLE. The Pittsburgh sleep quality index (PSQI) is a validated self-administered questionnaire that measures sleep quality over the previous month. The aim of this study was to analyse the relationship of sleep quality, measured by PSQI, with several variables including depression, anxiety, pain, disease activity, fatigue and functional disability in patients with SLE. A further aim was to establish the prevalence of poor sleep quality in SLE. Methods A cohort cross-sectional study was carried out including 92 SLE patients who fulfilled the SLICC classification criteria for SLE and who provided informed consent for participation. The patients were interviewed, and they were asked to fill in questionnaires including PSQI, Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), visual analogue scale (VAS) for pain and modified Health Assessment Questionnaire (mHAQ). Blood and urine tests enabled the calculation of SLE disease activity index-2K (SLEDAI-2K). The study was approved by the University Research Ethics Committee. Results 92.4% of the cohort studied were females, and the mean age was 46.9 years (range 19-79 years). 55.4% were noted to have poor quality sleep (PSQI >5), and the median PSQI was 6 (range 0-18). Sleep quality measured by PSQI, had a significant correlation with SLEDAI-2K (R = 0.254, p = 0.014), VAS pain (R = 0.515, p < 0.001), HADS-D (R = 0.605, p < 0.001), HADS-A (R = 0.375, p < 0.001), estimated glomerular filtration rate (eGFR) (R=-0.211, p = 0.044), FSS (R = 0.551, p < 0.001) and mHAQ (R = 0.559, p < 0.001). ANCOVA analysis showed that PSQI was significantly dependant on VAS pain (p < 0.001), HADS-D (p < 0.001) and eGFR (p = 0.003). Conclusion Poor sleep quality is highly prevalent in SLE patients. This study has shown that the strongest predictive factors for poor sleep quality are pain, depression and impaired renal function. Since poor sleep quality is significantly related to fatigue and functional disability, its identification and management is important for patients’ wellbeing. Disclosures R. Magro None. L. Camilleri None. A.A. Borg None.

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