Sleep disorders in patients with rheumatoid arthritis: association with quality of life, fatigue, depression levels, functional disability, disease duration, and activity: a multicentre cross-sectional study

Abstract

Objective To investigate the correlations between pain, quality of life, fatigue, levels of depression, disability and activity, and sleep quality and common sleep disorders in patients with rheumatoid arthritis (RA). Methods This multicentre, cross-sectional study enrolled patients with RA and sex- and age-matched control subjects. Clinical, sociodemographic, serological and therapeutic data were collected. Data from the Disease Activity Score (DAS28-CRP), the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire, a visual analogue scale to evaluate fatigue severity (VAS-F), health assessment questionnaire disability index (HAQ-DI) and the Center for Epidemiological Studies-depression (CES-D) score were analysed. Results The study enrolled 247 patients with RA (190 females and 57 males) and 60 control subjects (50 females and 10 males). The PSQI for patients with RA was significantly associated with the DAS28-CRP, HAQ-DI and VAS-F. There was a significant correlation between the CES-D score, the Berlin questionnaire and the HAQ-DI and the age of control subjects. Multiple linear regression analysis demonstrated that HAQ-DI (coefficient β = 0.103) and VAS-F (coefficient β = 0.028) significantly predicted the risk of sleep apnoea. Conclusion Patients with RA may suffer from poor sleep quality, which is attributed to depression, fatiguability, disability and disease activity.