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Song BW, Jeong HJ, Kim BY, Cho YW, Son CN, Kim SS, Kim SH. Bath Ankylosing Spondylitis Disease Activity Index is Associated With the Quality of Sleep in Ankylosing Spondylitis Patients. JOURNAL OF RHEUMATIC DISEASES 2021; 28:143-149. [PMCID: PMC10324903 DOI: 10.4078/jrd.2021.28.3.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 07/21/2023]
Abstract
Objective High disease activity of ankylosing spondylitis (AS) is associated with poor sleep quality The purpose of this study was to identify which of the representative tools for evaluating the disease activity of AS best reflect the quality of sleep Methods A total of 107 AS patients were enrolled in the study and the sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) Age, sex, concomitant medication, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) level, Beck Depression Inventory second edition (BDI-II), Bath ankylosing spondylitis disease activity index (BASDAI), ankylosing spondylitis disease activity score (ASDAS)-ESR, ASDAS-CRP, pain visual analog scale, Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) were analyzed as covariates Results Overall, 65% (70/107) of subjects reported poor sleep quality (PSQI>5) There was a positive correlation between the sleep quality and disease activity as measured by the BASDAI, ASDAS-ESR, and ASDAS-CRP In addition, the BASDAI demonstrated good correlations with ISI, ESS, and BDI-II, respectively However, only BASDAI showed reliable correlation with PSQI among the disease activity parameters of AS (adjusted odd ratio 5.36, p=0.023) Conclusion BASDAI is the most reliable parameter of disease activity associated with the sleep quality in patients with AS
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Affiliation(s)
- Byung Wook Song
- Division of Rheumatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Hye-Jin Jeong
- Division of Rheumatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Bo Young Kim
- Division of Rheumatology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Chang-Nam Son
- Division of Rheumatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Sung-Soo Kim
- Division of Rheumatology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Sang-Hyon Kim
- Division of Rheumatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
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Li Z, Fu T, Wang Y, Dong C, Shao X, Li L, Gu Z. Sleep disturbances in ankylosing spondylitis: a systematic review and meta-analysis. PSYCHOL HEALTH MED 2019; 24:911-924. [PMID: 31012756 DOI: 10.1080/13548506.2019.1574357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The aim of this meta-analysis was to compare sleep outcomes of AS patients and controls. Six electronic databases were searched: PubMed, Embase, IndMed, Cochrane Library, CNKI and Web of Science. Statistical analyses were executed using Revman 5.3 software. Nine studies and a total of 3169 participants were included in the meta-analysis. When sleep was assessed using PSQI, significant differences were observed in subjective sleep quality, sleep latency, sleep efficiency, sleep disorders, sleep medication use and total PSQI between patients with AS and controls, and subjective sleep quality was most severely affected. In PSG, eight variables of sleep quality (stage I sleep, stage II sleep, slow wave sleep, rapid eye movement, arousal index, periodic leg movement index, sleep latency, sleep efficiency) were lower in AS patients than in controls. Three variables of sleep quality assessed by USI (estimated sleep time, sleep sufficiency index, number of awakenings per night) and two variables of sleep quality assessed by MOS sleep scale (sleep disturbance scale, sleep problem index II) were lower in AS patients than in controls. It indicated that AS patients experience more serious sleep disorders. Early recognition and appropriate interventions are essential to improve patients' sleep quality.
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Affiliation(s)
- Zhenyu Li
- a Research Center of Gerontology and Longevity , Affiliated Hospital of Nantong University , Nantong , China.,b Department of Nursing , Affiliated Hospital of Nantong University , Nantong , China
| | - Ting Fu
- a Research Center of Gerontology and Longevity , Affiliated Hospital of Nantong University , Nantong , China
| | - Yilin Wang
- d Medical School of Nantong University , Nantong , China
| | - Chen Dong
- d Medical School of Nantong University , Nantong , China
| | - Xiaoyi Shao
- e Department of Immunology , Medical College of Nantong University , Nantong , China
| | - Liren Li
- d Medical School of Nantong University , Nantong , China
| | - Zhifeng Gu
- c Research Center of Clinical Medicine , Affiliated Hospital of Nantong University , Nantong , China.,f Department of Rheumatology , Affiliated Hospital of Nantong University , Nantong , China
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Nie A, Wang C, Song Y, Xie X, Yang H, Chen H. Prevalence and factors associated with disturbed sleep in outpatients with ankylosing spondylitis. Clin Rheumatol 2018; 37:2161-2168. [PMID: 29971585 DOI: 10.1007/s10067-018-4190-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/26/2018] [Accepted: 06/24/2018] [Indexed: 02/05/2023]
Abstract
Sleep disturbance is prevalent among patients with ankylosing spondylitis (AS) and is considered a multifactorial issue. The study was designed to investigate sleep disturbance and its associated factors in AS outpatients in Southwest China. Patients were recruited by convenience sampling in this cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI), the Bath AS Disease Activity Index (BASDAI), the Bath AS Functional Index (BASFI), the Bath AS Patient Global Score (BAS-G), and the Hospital Anxiety and Depression Scale (HADS) were used to assess sleep quality, disease activity, function status, global well-being, depression, and anxiety. Spearman's correlation, t test, ANOVA, and multiple linear regression analysis were used to explore the associated factors of sleep disturbance. Of the 281 outpatients included in the study, 190 (67.6%) patients had sleep disturbance. The married patients, the patients with extra-spinal manifestation, depression and anxiety, longer duration of diagnostic delay, higher disease activity, worse functional status and global well-being, high level of pain, and fatigue, had poorer sleep quality (P < 0.05). Multiple linear regression analysis revealed age (β = 0.087, P = 0.102), BAS-G (β = 0.181, P = 0.003), fatigue (β = 0.170, P = 0.002), anxiety (β = 0.151, P = 0.002) and nocturnal back pain (β = 0.192, P = 0.001), extra-spinal manifestation (β = 0.120, P = 0.012), and duration of diagnostic delay (β = 0.174, P = 0.001) were the contributors to PSQI. Sleep disturbance is common in AS patients in Southwest China. It may be useful to keep regular exercise, strengthen the management of pain, relieve anxiety, and prevent and treat extra-spinal manifestation for improving sleep quality.
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Affiliation(s)
- Anliu Nie
- West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Chen Wang
- Operation Unit, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Wuhou District, Chengdu, Sichuan Province, China
| | - Yuqing Song
- West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xia Xie
- West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Hui Yang
- West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Hong Chen
- West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Lee J, Kim SS, Jeong HJ, Son CN, Kim JM, Cho YW, Kim SH. Association of sleep quality in Behcet disease with disease activity, depression, and quality of life in Korean population. Korean J Intern Med 2017; 32:352-359. [PMID: 28192886 PMCID: PMC5339476 DOI: 10.3904/kjim.2016.367] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 12/06/2016] [Accepted: 12/07/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Sleep disturbance is prime concern in patients with Behcet disease. The purpose of this study was to find out the effects of sleep quality, in Korean patients suffering from Behcet disease. We further investigated the relationship between depression, quality of life and the clinical findings of Behcet disease. METHODS The study was performed by the cross-sectional design. Sleep quality was assessed by the Korean version of Pittsburgh sleep quality index (PSQI). Disease activity of Behcet disease was evaluated by Behcet disease current activity form (BDCAF). Depression was assessed by the Korean version of Beck depression inventory second edition (BDI-2). Quality of life was assessed by the Korean version of the Leeds Behcet disease quality of life measure (BDQoL). RESULTS Among the 100 patients studied, 42% reported poor sleep quality (PSQI ≥ 9). These patients have a higher BDI-2, total BDCAF and pain visual analogue scale (VAS) score (p < 0.001, p = 0.022, and p = 0.005). Considering BDCAF, the frequency of genital ulcer was significantly higher (p = 0.01). Behcet was higher in females. The BDQoL was lower in poor sleeper group (p = 0.004 and p < 0.001). Among 7 PSQI components, daytime dysfunction was higher in patients with high disease activity (p = 0.03). Total PSQI score were strongly correlated with BDCAF, BDI-2, BDQoL, and pain VAS score (p = 0.02, p < 0.001, p < 0.001, and p < 0.001, respectively). CONCLUSIONS Low sleep quality is directly associated with disease activity, depression, and quality of life in Korean patients with Behcet disease.
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Affiliation(s)
- Jimin Lee
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Sung-Soo Kim
- Division of Rheumatology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Hye-Jin Jeong
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Chang-Nam Son
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Ji-Min Kim
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Yong-Won Cho
- Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Sang-Hyon Kim
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
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Leverment S, Clarke E, Wadeley A, Sengupta R. Prevalence and factors associated with disturbed sleep in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a systematic review. Rheumatol Int 2016; 37:257-271. [PMID: 27796520 DOI: 10.1007/s00296-016-3589-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/22/2016] [Indexed: 12/12/2022]
Abstract
This review explores the prevalence and factors associated with disturbed sleep for patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis in order to clarify consistent findings in this otherwise disparate research field. The association of physical, demographic and psychological factors correlating with poor sleep was explored, and the effectiveness of interventions assessed. Ten electronic databases were searched: AMED, CINAHL, Embase, Medline, PsycINFO, PubMed, Scopus, Web of Science, OpenGrey and BASE. Following application of inclusion and exclusion criteria, 29 articles were critically assessed on the basis of methodology, experimental design, ethics and quality of sleep data, leading to the selection of 15 studies for final review. Poor sleep was reported in 35-90% of patients with axial spondyloarthritis and is more prevalent within this clinical population compared to healthy control subjects. Disturbed sleep is an important aspect of disease for patients and reflects the severity of disease activity, pain, fatigue and functional disability. However, the direction of this relationship is undetermined. Associations with age, gender, years spent in education, quality of life and depression have also been demonstrated. Anti-TNF medication is effective in reducing poor sleep, and exercise has also produced beneficial results. Future research into poor sleep should take account of its multifactorial nature. There is also a current lack of research investigating non-pharmacological interventions or combination therapies. A standardised, validated measurement of poor sleep, appropriate for regular patient screening, would be a useful first step for future research.
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Affiliation(s)
| | - Emily Clarke
- Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, BA1 1RL, UK
| | | | - Raj Sengupta
- Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, BA1 1RL, UK.
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Baek HJ. Sleep Disturbance in Patients with Ankylosing Spondylitis. JOURNAL OF RHEUMATIC DISEASES 2014. [DOI: 10.4078/jrd.2014.21.6.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Han Joo Baek
- Division of Rheumatology, Department of Internal Medicine, Gachon University School of Medicine, Gil Medical Center, Incheon, Korea
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