Pain characteristics and sleep dysregulation in patients with rheumatoid arthritis and ankylosing spondylitis: relationships with pain intensity and disease activity

Abstract

Background. Pain is a prominent manifestation in chronic immune-inflammatory rheumatic disorders, encompassing both nociceptive and non-nociceptive elements, the latter potentially resulting from central sensitization. The connection between inadequate sleep quality and the onset of central sensitization in individuals with chronic rheumatic diseases has been documented. Objectives. This study aimed to analyze the characteristics of pain, sleep quality, and their correlation with pain intensity and disease activity in adults with rheumatoid arthritis and ankylosing spondylitis. Methods. A prospective observational study was conducted, involving patients with RA, AS, and osteoarthritis. We evaluated pain intensity, pain characteristics, and sleep quality. Results. The study group included 152 patients. RA was primarily characterized by nociceptive pain, but AS exhibited a higher prevalence of neuropathic pain. Significant associations were found between PD-Q scores and disease activity in patients with RA, but no such correlations were identified in patients with AS. Individuals with AS showed a significant inverse correlation between PD-Q scores and pain intensity. The PSQI scores did not show any notable variations among the three groupings. The quality of sleep was found to be connected with disease activity in RA but not in AS. A substantial and noteworthy correlation was found between the overall PSQI score and the scores obtained from the PD-Q in both subgroups of RA and AS. Conclusion. Notable connections can be found between disease activity, pain characteristics, and sleep quality in chronic immune-inflammatory rheumatic diseases.

Keywords

• nociceptive pain
• neurophatic pain
• sleep quality
• disease activity
• ankylosing spondylitis
• rheumatoid arthritis
• osteoarthritis