Laboratory of Sleep and Biological Rhythms, Department of Medicine, Federal University of Ceara, Rua Prof. Costa Mendes 1608 - 4° andar, CEP 60430-971, Fortaleza, Ceara, Brazil.
Dr. Cesar Cals General Hospital, Fortaleza, Ceara, Brazil.
Adv Rheumatol. 2021 Mar 16;61(1):18. doi: 10.1186/s42358-021-00176-6.
To investigate the associations between sleep quality, fatigue, disease activity and depressive symptoms in women with rheumatoid arthritis (RA).
Female patients with previous diagnosis of RA from a Rheumatology Outpatient Clinic at a tertiary referral centre, in Fortaleza, Brazil, were consecutively recruited into the study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI); fatigue by the Fatigue Severity Scale (FSS); daytime sleepiness by the Epworth Sleepiness Scale (ESS); and depressive symptoms by the Beck Depression Inventory II (BDI-II). RA activity was measured by the disease activity score (DAS28).
One hundred ten women (mean age ± SD = 51.1 ± 13.0 y) were included in the study. On average, patients with depressive symptoms (BDI-II > 13), as compared to those without, showed poorer sleep quality (PSQI: 10.09 ± 4.1 vs 7.33 ± 3.55; p = 0.001 respectively), more fatigue (FSS: 4.69 ± 1.89 vs 3.34 ± 1.8; p = 0.001) and higher disease activity level (DAS28: 4.36 ± 1.53 vs 3.7 ± 1.39; p = 0,047). The logistic regression analysis showed that sleep quality is an independent predictor of depressive symptom severity.
Depressive symptoms, impaired sleep and fatigue are common in women with RA. Poor sleep is associated with greater frequency and severity of depressive symptoms in these patients, suggesting that screening for sleep and mood problems may be relevant both in clinical research and routine patient care. Future studies investigating the impact of measures to promote healthy sleep on depressive symptom control in this patient population are warranted.
调查女性类风湿关节炎（RA）患者的睡眠质量、疲劳、疾病活动度和抑郁症状之间的关系。
从巴西福塔雷萨的一家三级转诊中心的风湿病门诊连续招募了患有 RA 的女性患者。采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量；疲劳采用疲劳严重程度量表（FSS）评估；白天嗜睡采用 Epworth 嗜睡量表（ESS）评估；抑郁症状采用贝克抑郁量表 II （BDI-II）评估。RA 活动度采用疾病活动评分（DAS28）进行测量。
本研究共纳入 110 名女性（平均年龄±标准差=51.1±13.0 岁）。与无抑郁症状（BDI-II<13）的患者相比，有抑郁症状（BDI-II>13）的患者睡眠质量较差（PSQI：10.09±4.1 与 7.33±3.55；p 值分别为 0.001），疲劳程度较高（FSS：4.69±1.89 与 3.34±1.8；p 值分别为 0.001），疾病活动水平更高（DAS28：4.36±1.53 与 3.7±1.39；p 值为 0.047）。Logistic 回归分析显示，睡眠质量是抑郁症状严重程度的独立预测因子。
RA 女性患者中常见抑郁症状、睡眠障碍和疲劳。睡眠质量差与这些患者抑郁症状的频率和严重程度增加相关，这表明在临床研究和常规患者护理中筛查睡眠和情绪问题可能是相关的。未来研究调查改善睡眠健康的措施对该患者人群抑郁症状控制的影响是有必要的。
