Nearly two-thirds of patients with rheumatoid arthritis have at least one sleep disorder
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Nearly two-thirds of patients with rheumatoid arthritis meet the criteria for at least one sleep disorder, according to data published in Arthritis Care & Research.
“Specific sleep disorders, such as obstructive sleep apnea (OSA), restless legs syndrome (RLS), and short sleep, have been less studied in RA than perceived sleep quality, but also appear to be more common in RA than in the general population,” Patricia Katz, PhD, of the University of California, San Francisco, and colleagues wrote. “Sleep disorders likely have both unique causes and consequences in RA.”
To investigate the prevalence and impact of sleep disorders among patients with RA, Katz and colleagues used data from FORWARD, an ongoing, observational, longitudinal study based in the United States in which patients are enrolled via rheumatologists after receiving rheumatologic diagnoses. The present analysis included patients with a diagnosis of RA as confirmed by a provider who completed a comprehensive questionnaire in July 2016. Data were collected every 6 months via online questionnaire, telephone interview or paper mailer, depending on participants’ preferences.
The initial survey, conducted in July 2016, aimed to determine whether patients had symptoms of obstructive sleep apnea and restless leg syndrome. Additionally, the survey assessed patient outcomes on the Medical Outcomes Study Sleep Scale, and on short sleep times and the Medical Outcomes Study Sleep Problems Index. Other assessed variables included demographic characteristics, general health status, RA disease activity state and RA medications.
The analysis included a total of 4,200 patients with RA. Of those patients, 21% either had, or were at risk for, obstructive sleep apnea, while 30% demonstrated restless leg syndrome and 43% reported short sleep, defined as fewer than 6 hours per night. According to the researchers, patients using abatacept (Orencia, Bristol Myers Squibb) demonstrated lower odds of restless leg syndrome or short sleep duration. Additionally, patients with short sleep duration less commonly used abatacept or disease-modifying antirheumatic drugs. No medications appeared to be associated with obstructive sleep apnea.
“Sleep disorders and poor perceived sleep quality are common in this cohort of individuals with RA,” Katz and colleagues wrote. “Factors associated with sleep disorders were similar to those noted in the general population (eg, obesity, COPD). However, RA disease activity and pain were also significantly associated with each disorder.
“Additional research is needed to tease out the causal pathway for associations noted between sleep disorders and RA disease activity and pain, as well as to identify the long-term consequences of sleep disorders in RA,” they added.
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