Department of Internal Medicine Unit of Rheumatology, Hacettepe University Faculty of Medicine, No: 72/2 Çankaya, Ankara, Turkey.
Rheumatol Int. 2012 Jul;32(7):1909-13. doi: 10.1007/s00296-011-1907-x. Epub 2011 Mar 30.
Sleep disturbances and problems are increased in ankylosing spondylitis (AS). But much is not known in a quantitative way about sleep problems and effect of treatments on AS. This study is aimed first, to investigate sleep disturbances in AS and secondly, to evaluate the effects of anti-TNF treatment on SD in AS. One hundred seventy-one (Female/male: 90/81) AS patients fulfilling modified New York criteria and 86 (F/M: 56/30) age- and gender-matched controls without inflammatory diseases were included into the study. Demographic data and disease activity and treatments were recorded using The Bath Ankylosing Spondylitis Functional Index (BASFI) and The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The Medical Outcomes Study (MOS) Sleep Questionnaire was used for evaluating sleep and problems of sleep. AS patients had higher sleep disturbance scale (SDS) and sleep problem index (SPI) II scores. Group A (patients using NSAID and/or DMARD, 53.2% of patients) had higher BASDAI and BASFI compared with Group B (Patients using anti-TNF treatments) (4.29 ± 2.38 vs. 2.46 ± 2.32, p < 0.001; 1.95 ± 2.15 vs. 0.93 ± 1.31, p < 0.001, respectively). Whereas Group A had higher scores of SDS, awaken short of breath or headache, somnolence, and SPI-II than controls, none of the sleep parameters were statistically different between patients on anti-TNF treatments and controls. BASDAI was positively correlated with SPI-I, SPI-II, SDS, and somnolence scale. AS patients had increased sleep problems and disturbances compared with controls. Anti-TNF agents improve significantly these problems. Sleep problems are significantly correlated with the disease activity.
强直性脊柱炎（AS）患者睡眠障碍和问题增多。但对于睡眠问题以及治疗对 AS 的影响，目前还没有太多定量的了解。本研究旨在：首先，研究 AS 患者的睡眠障碍；其次，评估抗 TNF 治疗对 AS 患者睡眠障碍的影响。本研究共纳入 171 例（男/女：90/81）符合改良纽约标准的 AS 患者和 86 例（男/女：56/30）年龄和性别匹配的无炎症性疾病对照者。使用 Bath 强直性脊柱炎功能指数（BASFI）和 Bath 强直性脊柱炎疾病活动指数（BASDAI）记录人口统计学数据、疾病活动度和治疗情况。使用医疗结局研究（MOS）睡眠问卷评估睡眠和睡眠问题。AS 患者的睡眠障碍量表（SDS）和睡眠问题指数（SPI）Ⅱ评分较高。A 组（使用 NSAID 和/或 DMARD 的患者，占患者的 53.2%）的 BASDAI 和 BASFI 高于 B 组（使用抗 TNF 治疗的患者）（4.29±2.38 比 2.46±2.32，p<0.001；1.95±2.15 比 0.93±1.31，p<0.001）。A 组 SDS、呼吸急促或头痛觉醒、嗜睡和 SPI-II 评分高于对照组，但抗 TNF 治疗组患者与对照组患者的所有睡眠参数均无统计学差异。BASDAI 与 SPI-I、SPI-II、SDS 和嗜睡量表呈正相关。与对照组相比，AS 患者的睡眠问题和障碍增加。抗 TNF 药物显著改善这些问题。睡眠问题与疾病活动度显著相关。
