Anti-Citrullinated Cyclic Peptide Antibody and Functional Disability Are Associated With Poor Sleep Quality in Rheumatoid Arthritis

Factors That Influence Sleep Disturbance and the Mediating Effects of Depression on Sleep Disturbance in Patients With Rheumatoid Arthritis

Little is known about the nature of relationships between sleep disturbance and influencing factors in rheumatoid arthritis. The purpose of this study was to identify factors that influence sleep disturbance and to evaluate mediating effects of depression on sleep disturbance. A nonexperimental, descriptive, correlational study design was adopted. One hundred patients with rheumatoid arthritis were recruited. Inflammatory status and levels of pain, fatigue, functional disability, depression, and sleep disturbance were measured. The factors that directly influenced sleep disturbance were gender, rheumatoid arthritis duration, serum C-reactive protein level, fatigue, and depression. Depression was found to have mediating effects on the relationships between sleep disturbance and arthritis symptoms. Pain, fatigue, and depression were found to have significant direct or indirect impacts on sleep disturbance. Our findings may improve understanding of sleep disturbance and aid the development of effective nursing management strategies for patients with rheumatoid arthritis suffering from sleep disturbance.

Rheumatoid arthritis is associated with negatively variable impacts on domains of sleep disturbances: evidence from a systematic review and meta-analysis

The aim of this study was to identify the impact of rheumatoid arthritis (RA) on specific sleep quality domains and to determine its prevalence. A systematic literature search was performed on PubMed, Web of Science, Cochrane Library, and Embase until January 2018 to obtain eligible studies. Score of the Pittsburgh Sleep Quality Index (PSQI) was used as the outcome measurement, and weight mean differences (WMD) with 95% confidence intervals (CI) were calculated. In total, eight studies were eligible for inclusion criteria, comprising 658 RA patients and 485 healthy controls. In this meta-analysis, each domain of the PSQI score: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disorders, use of sleep medication, daytime dysfunction and the total score were higher in RA patients than healthy controls. In addition, the relative risk of sleep disturbances among people with RA was 2.37 (95% CI: 1.80, 3.11) compared with people without RA.In conclusion, RA patients scored higher in each dimension of PSQI, and sleep disturbances was more prevalent in RA patients than in controls. Further research is needed to identify effective strategies for preventing and treating sleep disturbances among RA patients.