From the University of British Columbia, Vancouver, British Columbia; the Department of Medicine, Division of Rheumatology, and Department of Laboratory Medicine and Pathobiology, and the Institute of Medical Science, University of Toronto; Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, and Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
I.T. Wong, BSc (Pharmacy), Medical Student, University of British Columbia; V. Chandran, MBBS, MD, DM, PhD, Assistant Professor, Department of Medicine, Division of Rheumatology, and Department of Laboratory Medicine and Pathobiology, and Institute of Medical Science, University of Toronto, and Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network; S. Li, MMath, Biostatistician, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, and Toronto Western Hospital, University Health Network; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Krembil Research Institute, and Director of the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, and Toronto Western Hospital, University Health Network.
J Rheumatol. 2017 Sep;44(9):1369-1374. doi: 10.3899/jrheum.161330. Epub 2017 Jun 15.
We aimed to determine the prevalence and quality of sleep in patients with psoriatic arthritis (PsA) and those with psoriasis without PsA (PsC) followed in the same center, to identify factors associated with sleep disturbance, and to compare findings to those of healthy controls (HC).
The study included 113 PsA [ClASsification for Psoriatic ARthritis (CASPAR) criteria] and 62 PsC (PsA excluded by a rheumatologist) patients and 52 HC. Clinical variables were collected using a standard protocol. The sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Other patient-reported outcomes collected included the Health Assessment Questionnaire (HAQ), Dermatology Life Quality Index, EQ-5D, Medical Outcomes Study Short Form-36 survey, patient's global assessment, and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) scale. Statistical analyses included descriptive statistics, Wilcoxon rank-sum test, and linear regression.
The prevalence of poor sleep quality was 84%, 69%, and 50% in PsA, PsC, and HC, respectively. Total PSQI score was higher in both patients with PsA and patients with PsC compared with HC (p < 0.01) and higher in patients with PsA compared to patients with PsC (p < 0.0001). EQ-5D anxiety component, EQ-5D final, and FACIT-fatigue were independently associated with worse PSQI in patients with PsC and those with PsA (p < 0.05). Actively inflamed (tender or swollen) joints are independently associated with worse PSQI in patients with PsA (p < 0.01).
Patients with psoriatic disease have poor sleep quality. Poor sleep is associated with fatigue, anxiety, and lower EQ-5D. In patients with PsA, poor sleep is associated with active joint inflammation.
我们旨在确定在同一中心就诊的银屑病关节炎（PsA）和无银屑病关节炎（PsC）的银屑病患者的睡眠患病率和质量，确定与睡眠障碍相关的因素，并将研究结果与健康对照组（HC）进行比较。
该研究纳入了 113 名 PsA（银屑病关节炎分类标准）和 62 名 PsC（由风湿病学家排除的 PsA）患者以及 52 名 HC。使用标准方案收集临床变量。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。收集的其他患者报告结果包括健康评估问卷（HAQ）、皮肤病生活质量指数、EQ-5D、医疗结局研究短表 36 调查、患者总体评估和慢性病治疗疲劳功能评估-疲劳量表（FACIT-fatigue）。统计分析包括描述性统计、Wilcoxon 秩和检验和线性回归。
PsA、PsC 和 HC 患者的睡眠质量差的患病率分别为 84%、69%和 50%。与 HC 相比，PsA 和 PsC 患者的 PSQI 总分均较高（p<0.01），且 PsA 患者的 PSQI 总分高于 PsC 患者（p<0.0001）。在 PsC 和 PsA 患者中，EQ-5D 焦虑分量表、EQ-5D 终末评分和 FACIT-fatigue 独立与 PSQI 较差相关（p<0.05）。活动关节炎症（压痛或肿胀）与 PsA 患者的 PSQI 较差独立相关（p<0.01）。
患有银屑病的患者睡眠质量较差。睡眠质量差与疲劳、焦虑和较低的 EQ-5D 有关。在 PsA 患者中，睡眠质量差与活动关节炎症有关。
