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类风湿关节炎患者的睡眠质量及其与疼痛、残疾、病程和活动的关系

Sleep Quality in Patients with Rheumatoid Arthritis and Associations with Pain, Disability, Disease Duration, and Activity.

作者信息

Grabovac Igor, Haider Sandra, Berner Carolin, Lamprecht Thomas, Fenzl Karl-Heinrich, Erlacher Ludwig, Quittan Michael, Dorner Thomas E

机构信息

Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.

Department of Rheumatology and Osteology, Kaiser Franz Josef Hospital, Sozialmedizinisches Zentrum Süd, Kundratstrasse 3, 1100 Vienna, Austria.

出版信息

J Clin Med. 2018 Oct 9;7(10):336. doi: 10.3390/jcm7100336.

Abstract

We aimed to assess the subjective sleep quality in patients with rheumatoid arthritis (RA) and its correlation with disease activity, pain, inflammatory parameters, and functional disability. In a cross-sectional study, patients with confirmed RA diagnosis responded to a questionnaire (consisting of socio-demographic data, the Health Assessment Questionnaire Disability Index, and the Medical Outcome Study Sleep Scale). Disease activity was assessed with the Clinical Disease Activity Index, and pain levels using the visual analogue scale. In addition, inflammatory markers (C-reactive protein, interleukin-6, and tumor necrosis factor alpha) were analyzed. Ninety-five patients were analyzed, predominantly female, with an average age of 50.59 (9.61) years. Fifty-seven percent reported non-optimal sleep duration, where functional disability (92.7% vs. 69.8%; = 0.006) and higher median pain levels (3.75 (2.3⁻6.0) vs. 2.5 (2.0⁻3.5); = 0.003) were also more prevalent. No differences in sociodemographic variables, disease duration or activity, inflammatory parameters, or use of biological and corticosteroid therapy were observed. The multivariate regression analysis showed that more intense pain was associated with a lower likelihood of optimal sleep (odds ratio (OR) = 0.68, 95% confidence interval (CI) 0.47⁻0.98, = 0.038). Patients with RA report a high prevalence of non-optimal sleep, which is linked to pain level. Clinicians need to be aware of this issue and the potential effects on health and functional status.

摘要

我们旨在评估类风湿关节炎(RA)患者的主观睡眠质量及其与疾病活动度、疼痛、炎症参数和功能残疾的相关性。在一项横断面研究中,确诊为RA的患者回答了一份问卷(包括社会人口统计学数据、健康评估问卷残疾指数和医学结局研究睡眠量表)。使用临床疾病活动指数评估疾病活动度,使用视觉模拟量表评估疼痛程度。此外,还分析了炎症标志物(C反应蛋白、白细胞介素-6和肿瘤坏死因子α)。对95例患者进行了分析,其中以女性为主,平均年龄为50.59(9.61)岁。57%的患者报告睡眠时长不理想,功能残疾(92.7%对69.8%;P = 0.006)和较高的疼痛中位数水平(3.75(2.3⁻6.0)对2.5(2.0⁻3.5);P = 0.003)也更为普遍。在社会人口统计学变量、病程或活动度、炎症参数或生物和皮质类固醇治疗的使用方面未观察到差异。多因素回归分析显示,疼痛越剧烈,睡眠理想的可能性越低(优势比(OR)= 0.68,95%置信区间(CI)0.47⁻0.98,P = 0.038)。RA患者报告睡眠不理想的患病率较高,这与疼痛程度有关。临床医生需要意识到这个问题以及对健康和功能状态的潜在影响。

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