scholarly journals A Multidimensional Model of Fatigue in Patients with Rheumatoid Arthritis

2012 ◽  
Vol 39 (9) ◽  
pp. 1807-1813 ◽  
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.

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

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

scholarly journals Mediating effects of rumination and bedtime procrastination on the relationship between Internet addiction and poor sleep quality

2021 ◽  
Vol 9 (4) ◽  
pp. 1002-1010
Author(s):  
Zhiqi You ◽  
Weijie Mei ◽  
Na Ye ◽  
Lu Zhang ◽  
Frank Andrasik
Keyword(s):  
Sleep Quality ◽  
Internet Addiction ◽  
Structural Equation ◽  
Online Survey ◽  
Equation Modeling ◽  
Poor Sleep ◽  
Mediating Effects ◽  
Poor Sleep Quality ◽  
Convenience Sample ◽  
Bedtime Procrastination

AbstractBackground and aimsNumerous studies have shown that people who have Internet addiction (IA) are more likely to experience poor sleep quality than people who do not. However, few studies have explored mechanisms underlying the relation between IA and poor sleep quality. As a first attempt to address this knowledge gap, a cross-sectional design was applied, and structural equation modeling was used to explore the direct relationship between IA and poor sleep quality, as well as the potential mediating roles of rumination and bedtime procrastination.MethodsA convenience sample, consisting of 1,104 Chinese University students (696 females or 63%), completed an online survey that included the following measures: Young’s 8-item Internet Addiction Diagnosis Questionnaire, the Pittsburgh Sleep Quality Index, the Ruminative Responses Scale, and the Bedtime Procrastination Scale.ResultsWhile the direct path between IA and poor sleep quality was not found to be significant, rumination and bedtime procrastination were each shown to separately mediate the predictive effect of IA on poor sleep quality. However, the greatest level of support was found for the sequential mediating effects of rumination and bedtime procrastination between IA and poor sleep quality.ConclusionWhile rumination and bedtime procrastination were both shown to be important independent mediators for the relation between IA and poor sleep quality, their combined effect was as great as either alone.

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

2020 ◽  
Author(s):  
Mark Hughes ◽  
Alan Chalk ◽  
Poonam Sharma ◽  
Sandeep Dahiya ◽  
James Galloway
Keyword(s):  
Rheumatoid Arthritis ◽  
Sleep Quality ◽  
Cross Sectional Study ◽  
Poor Sleep ◽  
Comorbid Depression ◽  
Poor Sleep Quality ◽  
Cross Sectional ◽  
Rheumatoid Arthritis Population ◽  
Impaired Sleep

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 Problems in Patients with Rheumatoid Arthritis

2013 ◽  
Vol 41 (1) ◽  
pp. 31-40 ◽  
Author(s):  
René Westhovens ◽  
Kristien Van der Elst ◽  
Ann Matthys ◽  
Michelle Tran ◽  
Isabelle Gilloteau
Keyword(s):  
Rheumatoid Arthritis ◽  
Sleep Quality ◽  
Disease Activity ◽  
Daytime Sleepiness ◽  
Sleep Problems ◽  
Short Form ◽  
Negative Relationship ◽  
Additional Patient ◽  
Equation Modeling ◽  
Patient Reported

Objective.To investigate sleep problems, and the relationship between sleep and disease activity, in Belgian patients with established rheumatoid arthritis (RA).Methods.This cross-sectional, observational, multicenter study assessed sleep quality using the Athens Insomnia Scale (AIS) and Pittsburgh Sleep Quality Index (PSQI), and daytime sleepiness using the Epworth Sleepiness Scale (ESS). Additional patient-reported outcomes included visual analog scales (VAS) for fatigue and pain, the Medical Outcomes Study Short Form-36 Health Survey, the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the Positive and Negative Affect Schedule. Multivariate regression and structural equation modeling identified factors associated with sleep quality, with the 28-joint Disease Activity Score [DAS28-C-reactive protein (CRP)] as a continuous or categorical variable. Analyses were performed on the total population and on patients stratified by disease activity status: remission/low (DAS28-CRP ≤ 3.2) or moderate to high (DAS28-CRP > 3.2).Results.Among 305 patients, mean (SD) age was 57.00 (12.38) years and mean (SD) disease duration was 11.77 (9.94) years. Mean (SD) AIS, PSQI, and ESS scores were 6.8 (4.79), 7.8 (4.30), and 7.3 (4.67), respectively. Mean (SD) VAS fatigue, VAS pain, and HAQ-DI were 45.22 (26.29), 39.04 (26.21), and 1.08 (0.75), respectively. There were significant positive relationships between DAS28-CRP and AIS/PSQI, but a significant negative relationship between DAS28-CRP and ESS. Several potentially confounding factors were identified.Conclusions.Poor control of RA is associated with a reduction in sleep quality and decreased daytime sleepiness, which is likely explained by pain-related alertness. Future prospective studies are needed to confirm potential relationships between sleep quality, sleepiness, and RA treatment.

scholarly journals COVID-19 Uncertainty and Sleep: The Roles of Perceived Stress and Intolerance of Uncertainty during the Early Stage of the COVID-19 Outbreak

2021 ◽  
Author(s):  
Dan Wu ◽  
Tingzhong Yang ◽  
Daniel Hall ◽  
Guihua Jiao ◽  
Can Jiao
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Perceived Stress ◽  
Structural Equation ◽  
Early Stage ◽  
Intolerance Of Uncertainty ◽  
Self Report ◽  
Equation Modeling ◽  
Poor Sleep ◽  
Cross Sectional

Abstract Background. The COVID-19 pandemic brings unprecedented uncertainty and stress. This study aimed to characterize sleep behaviors among Chinese residents during the early stage of the outbreak and to test the extent to which sleep quality was driven by COVID-19 uncertainty, intolerance of uncertainty, and perceived stress. Methods. A cross-sectional correlational survey was conducted online. A total of 2,534 Chinese residents were recruited from February 7 to 14, 2020, the third week of lockdown. Self-report measures assessed uncertainty about COVID-19, intolerance of uncertainty, perceived stress, and sleep quality. Structural equation modeling was applied to test the relationships among uncertainty about COVID-19, intolerance of uncertainty, perceived stress, and sleep quality. Results. Sleep disturbance was common, with approximately half of participants (47.1%) reporting going to bed after 12:00am, 23.0% taking 30 minutes or longer to fall asleep, and 30.3% sleeping a total of 7 hours or less. Higher uncertainty about COVID-19 was significantly positively correlated with higher intolerance of uncertainty (r = 0.506, p < 0.001). Uncertainty about COVID-19 had a weak direct effect on poor sleep (β = 0.043, p < 0.05); however, there was a robust indirect effect on poor sleep through intolerance of uncertainty (β = 0.506, p < 0.001) and perceived stress (β = 0.479, p < 0.001). Conclusions. These findings suggest that intolerance of uncertainty and perceived stress are critical targets for reducing sleep disturbance during the COVID-19 pandemic. Given the sustained uncertainties and challenges managing COVID-19, it is likely that, if unmanaged, COVID-19 related uncertainty will persist and continue to impact sleep outcomes.

scholarly journals P171 Factors determining sleep quality in SLE

Rheumatology ◽  
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 &gt;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 &lt; 0.001), HADS-D (R = 0.605, p &lt; 0.001), HADS-A (R = 0.375, p &lt; 0.001), estimated glomerular filtration rate (eGFR) (R=-0.211, p = 0.044), FSS (R = 0.551, p &lt; 0.001) and mHAQ (R = 0.559, p &lt; 0.001). ANCOVA analysis showed that PSQI was significantly dependant on VAS pain (p &lt; 0.001), HADS-D (p &lt; 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.

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

2019 ◽  
Author(s):  
Alicia M Hinze ◽  
Philip Chu ◽  
Deepali P Sen ◽  
Noor Al-Hammadi ◽  
Yo-El S Ju ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Disease Activity ◽  
Poor Sleep ◽  
Poor Sleep Quality

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

2017 ◽  
Vol 11 (suppl_1) ◽  
pp. S173-S174 ◽  
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

Dose-response Relationship between Sleep and Rheumatoid Arthritis

2020 ◽  
Vol 44 (1) ◽  
pp. 40-53
Author(s):  
Wenwen Wu ◽  
Jinru Yang ◽  
Yaohua Gu ◽  
Xuyu Chen ◽  
Xiaodong Tan
Keyword(s):  
Rheumatoid Arthritis ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Low Income ◽  
Rural Areas ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Increased Risk

Objectives: In this study, we explored the association between sleep quality, duration and prevalence of rheumatoid arthritis (RA) among low-income adults in rural areas of China. Methods: Face-to-face investigation were conducted in 2017, and completed questionnaires were obtained from 16,648 individuals. Sleep quality and duration were evaluated using the standard Pittsburgh Sleep Quality Index. RA was based on self-reported physician diagnosis. Logistic regression analysis and restricted cubic spline models were performed. Results: Sleep duration shorter than 7 hours was associated with increased odds of RA, with an odds ratio (OR) of 1.49 for 6–<7 hours and 1.70 for <6 hours. Poor sleep quality was associated with RA, with an OR of 1.68. The combination category of poor sleep quality and any group of sleep duration was associated with a significantly increased risk of developing RA. Combined groups of good sleep quality with short sleep duration (<7 hours) were also found to be related to prevalence of RA. There was a non-linear relationship between sleep quality, duration and the odds of RA. Conclusions: Poor sleep quality and short sleep duration may be trigger or risk factors for RA.

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