Department of Pediatrics, Technion Institution, Pediatric Department Rheumatology Unit, Technion Faculty of Medicine, Meyer Children’s Hospital of Haifa, Haifa, Israel.
Rheumatology (Oxford). 2011 Nov;50(11):2051-60. doi: 10.1093/rheumatology/ker256. Epub 2011 Aug 25.
To determine and compare the prevalence of disturbed sleep in JIA and JDM and the relationship of sleep disturbance to pain, function, disease activity and medications.
One hundred fifty-five patients (115 JIA, 40 JDM) were randomly sampled and were mailed questionnaires. Sleep disturbance was assessed by the sleep self-report (SSR) and the children's sleep habits questionnaire (CSHQ). Fatigue, pain and function were assessed by the paediatric quality of life inventory (PedsQL) and disease activity by visual analogue scales (VASs). Joint counts were self-reported.
Eighty-one per cent responded, of whom 44% reported disturbed sleep (CSHQ > 41); there were no differences between disease groups. Poor reported sleep (SSR) was highly correlated with PedsQL fatigue (r = 0.56, P < 0.0001). Fatigue was highly negatively correlated with quality of life (r = -0.77, P < 0.0001). The worst pain intensity in the last week was correlated to sleep disturbance (r = 0.32, P = 0.0005). Fatigue was associated with prednisone and DMARD use.
Sleep disturbance and fatigue are prevalent among children with different rheumatic diseases. Sleep disturbance and fatigue are strongly associated with increased pain and decreased quality of life. Strategies aimed at improving sleep and reducing fatigue should be studied as possible ways of improving quality of life for children with rheumatic illness.
确定并比较幼年特发性关节炎（JIA）和幼年皮肌炎（JDM）患者睡眠障碍的患病率，以及睡眠障碍与疼痛、功能、疾病活动度和药物之间的关系。
随机抽取 155 名患者（115 名 JIA，40 名 JDM）并邮寄调查问卷。通过睡眠自评量表（SSR）和儿童睡眠习惯问卷（CSHQ）评估睡眠障碍。疲劳、疼痛和功能采用儿童生活质量量表（PedsQL）评估，疾病活动度采用视觉模拟评分（VAS）评估。关节计数由患者自行报告。
81%的患者做出回应，其中 44%的患者报告存在睡眠障碍（CSHQ＞41）；两组间无差异。较差的睡眠自评（SSR）与 PedsQL 疲劳高度相关（r=0.56，P＜0.0001）。疲劳与生活质量高度负相关（r=-0.77，P＜0.0001）。过去一周内最严重的疼痛强度与睡眠障碍相关（r=0.32，P=0.0005）。疲劳与泼尼松和 DMARD 的使用相关。
不同风湿性疾病患儿中睡眠障碍和疲劳均较为普遍。睡眠障碍和疲劳与疼痛加重和生活质量下降高度相关。应研究改善睡眠和减轻疲劳的策略，以作为提高风湿性疾病患儿生活质量的可能途径。
