Løppenthin K, Esbensen B A, Jennum P, Østergaard M, Tolver A, Thomsen T, Midtgaard J
Research Unit of Nursing and Health Science, Glostrup Hospital, University of Copenhagen, Ndr. Ringvej 57, 2600, Copenhagen, Denmark.
Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
Clin Rheumatol. 2015 Dec;34(12):2029-39. doi: 10.1007/s10067-015-2875-4. Epub 2015 Jan 27.
The objective of this study is to examine sleep quality and correlates of poor sleep in patients with rheumatoid arthritis (RA). Five hundred patients with RA were recruited from a rheumatology outpatient clinic and included in this cross-sectional study. Sleep quality and disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI). Other instruments included the Multidimensional Fatigue Inventory, the Epworth Sleepiness Scale, and the Health Assessment Questionnaire. Disease activity was assessed according to disease activity score DAS28-CRP-based. Complete scores on PSQI were obtained from 384 patients (77 %). In those, the prevalence of poor sleep (PSQI >5) was 61 %, and the mean global PSQI score was 7.54 (SD 4.17). A linear association was found between poor sleep and mental fatigue, reduced activity related to fatigue, physical fatigue, and general fatigue. Mental fatigue and general fatigue were independently associated with sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction. However, in the linear multivariate analysis, only general fatigue 1.06 (95 % CI 1.03-1.09) and mental fatigue 1.03 (95 % CI 1.01-1.05) were found to be significant correlates for reporting poor sleep. This study shows that a majority of patients with RA experience poor sleep and that general fatigue and mental fatigue are associated with poor sleep.
本研究的目的是调查类风湿关节炎（RA）患者的睡眠质量及其睡眠不佳的相关因素。从风湿病门诊招募了500例RA患者，并纳入这项横断面研究。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量和睡眠障碍。其他工具包括多维疲劳量表、爱泼华嗜睡量表和健康评估问卷。根据基于疾病活动评分DAS28-CRP评估疾病活动度。从384例患者（77%）中获得了完整的PSQI评分。在这些患者中，睡眠不佳（PSQI>5）的患病率为61%，PSQI总体平均评分为7.54（标准差4.17）。发现睡眠不佳与精神疲劳、与疲劳相关的活动减少、身体疲劳和全身疲劳之间存在线性关联。精神疲劳和全身疲劳与睡眠质量、入睡潜伏期、睡眠时间、睡眠效率和日间功能障碍独立相关。然而，在多元线性分析中，仅发现全身疲劳1.06（95%可信区间1.03-1.09）和精神疲劳1.03（95%可信区间1.01-1.05）是报告睡眠不佳的显著相关因素。这项研究表明，大多数RA患者存在睡眠不佳的情况，且全身疲劳和精神疲劳与睡眠不佳有关。
