55 Poor sleep quality assessed subjectively associated with worsening SLE disease activity

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

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjx002.317 ◽

2017 ◽

Vol 11 (suppl_1) ◽

pp. S173-S174 ◽

Cited By ~ 1

Author(s):

M.A. Sofia ◽

A.M. Lipowska ◽

E.Y. Perez ◽

N. Zmeter ◽

R.T. Kavitt ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Sleep Quality ◽

Disease Activity ◽

Poor Sleep ◽

Poor Sleep Quality

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Rumination and dissociation: The mediating role of poor sleep quality and presleep cognitions.

Psychology of Consciousness Theory Research and Practice ◽

10.1037/cns0000128 ◽

2018 ◽

Vol 5 (2) ◽

pp. 185-211 ◽

Cited By ~ 2

Author(s):

Miriam Vannikov-Lugassi ◽

Nirit Soffer-Dudek

Keyword(s):

Sleep Quality ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Mediating Role

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Poor sleep quality and its relationship to attentional-executive dysfunctioning in depressive inpatients

10.1055/s-0037-1606395 ◽

2017 ◽

Author(s):

B Kundermann ◽

S Fockenberg ◽

M Müller ◽

N Cabanel

Keyword(s):

Sleep Quality ◽

Poor Sleep ◽

Poor Sleep Quality

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Psychological Distress Mediates the Association between Poor Sleep Quality and Prediabetes

Diabetes ◽

10.2337/db18-865-p ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 865-P

Author(s):

LI LI

Keyword(s):

Psychological Distress ◽

Sleep Quality ◽

Poor Sleep ◽

Poor Sleep Quality

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Association of severity of depressive symptoms with sleep quality, social support and stress among Pakistani medical and dental students: A cross-sectional study

Global Psychiatry ◽

10.2478/gp-2019-0019 ◽

2019 ◽

Vol 2 (2) ◽

pp. 211-220

Author(s):

Ahmed Waqas ◽

Aqsa Iftikhar ◽

Zahra Malik ◽

Kapil Kiran Aedma ◽

Hafsa Meraj ◽

...

Keyword(s):

Social Support ◽

Depressive Symptoms ◽

Medical Students ◽

Sleep Quality ◽

Severe Depression ◽

Dental Students ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Cross Sectional ◽

Medical And Dental Students

AbstractObjectivesThis study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school. There is a paucity of data on social support among medical students in Pakistan; an important predictor of depressive symptoms. Therefore, this study was also aimed to demonstrate the direct and indirect impact of social support in alleviating depressive symptoms in the study sample.MethodsThis observational cross-sectional study was conducted in Lahore, Pakistan, where a total of 400 students at a medical school were approached between 1st January to 31st March 2018 to participate in the study. The study sample comprised of medical and dental students enrolled at a privately financed Pakistani medical and dental school. The participants responded to a self-administered survey comprising of five parts: a) demographics, b) Pittsburgh Sleep Quality Index (PSQI), c) Patient Health Questionnaire-9 (PHQ-9), d) Multidimensional Scale of Perceived Social Support (MSPSS) and e) Perceived Stress Scale-4 (PSS-4). All data were analysed using SPSS v. 20. Linear regression analysis was used to reveal the predictors of depression.ResultsIn total, 353 medical students participated, yielding a response rate of 88.25%. Overall, poor sleep quality was experienced by 205 (58.1%) students. Mild to severe depression was reported by 83% of the respondents: mild depression by 104 (29.5%), moderate depression by 104 (29.5%), moderately severe depression by 54 (15.3%) and severe depression by 31 (8.8%) respondents. Subjective sleep quality, sleep latency, daytime dysfunction and stress levels were significantly associated with depression symptoms. Social support was not significantly associated with depressive symptoms in the regression model (Beta = -0.08, P < 0.09); however, it acted as a significant mediator, reducing the strength of the relationship between depressive symptoms and sleep quality and stress.ConclusionsAccording to our study, a large proportion of healthcare (medical and dental) students were found to be suffering from mild to moderate depression and experienced poor sleep quality. It is concluded that social support is an important variable in predicting depressive symptomatology by ameliorating the effects of poor sleep quality and high stress levels.

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