QualityMetric Incorporated, Johnston, RI, USA.
GSK, Global Value Evidence and Outcomes, 1250 South Collegeville Road, Building 4, 4th floor, Collegeville, PA, 19426, USA.
Qual Life Res. 2024 Feb;33(2):373-385. doi: 10.1007/s11136-023-03524-9. Epub 2023 Oct 27.
This qualitative study (GSK study: 213635) was designed to better understand sleep disturbance as experienced by individuals with rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA), and the relationship between sleep disturbance and pain and other aspects of the disease and disease activity.
Sixty-minute, one-on-one, concept elicitation interviews were conducted with 30 participants (15 with RA and 15 with axSpA) from the US. Interviews were audio-recorded and transcribed verbatim. Interview transcripts were coded and analyzed to explore themes related to pain and sleep disturbance, and relationships among those themes.
Pain was a prominent driver of sleep disturbance; 12 participants with RA (80%) and 14 with axSpA (93%) reported that pain impacted their ability to fall asleep, while all 15 with RA (100%) and 14 with axSpA (93%) reported that pain impacted their ability to stay asleep. Two-thirds of participants with RA (67%) or axSpA (60%) described a bi-directional relationship, whereby pain worsened sleep disturbance and sleep disturbance further aggravated pain. Factors other than pain, such as fatigue and emotional health, were also reported as important contributors to sleep disturbance (RA: n = 12/15, 80%; axSpA: n = 14/15, 93%). Participants with RA or axSpA described complex interconnections between fatigue, emotional health, pain, and sleep, often labeling these relationships as "vicious cycles". Notably, half of all participants reported sleep disturbance occurring without pain or other understood causes.
These perspectives collected from people with RA or axSpA suggest that reducing sleep disruption directly may offer clinically relevant benefits.
这项定性研究（GSK 研究：213635）旨在更好地了解类风湿关节炎（RA）或中轴型脊柱关节炎（axSpA）患者的睡眠障碍，并深入了解睡眠障碍与疼痛及疾病和疾病活动的其他方面之间的关系。
从美国招募了 30 名参与者（15 名 RA 患者和 15 名 axSpA 患者）进行了 60 分钟的一对一概念启发访谈。访谈进行了录音并逐字转录。对访谈记录进行编码和分析，以探讨与疼痛和睡眠障碍相关的主题，以及这些主题之间的关系。
疼痛是导致睡眠障碍的主要因素；12 名 RA 患者（80%）和 14 名 axSpA 患者（93%）报告说疼痛影响入睡能力，而所有 15 名 RA 患者（100%）和 14 名 axSpA 患者（93%）报告说疼痛影响了他们的睡眠持续时间。三分之二的 RA 患者（67%）或 axSpA 患者（60%）描述了一种双向关系，即疼痛使睡眠障碍恶化，而睡眠障碍又进一步加重了疼痛。除了疼痛之外，其他因素，如疲劳和情绪健康，也被认为是睡眠障碍的重要原因（RA：n=12/15，80%；axSpA：n=14/15，93%）。RA 或 axSpA 患者描述了疲劳、情绪健康、疼痛和睡眠之间复杂的相互关系，通常将这些关系称为“恶性循环”。值得注意的是，所有参与者中有一半报告说，睡眠障碍的发生没有疼痛或其他已知原因。
这些从 RA 或 axSpA 患者收集的观点表明，直接减少睡眠中断可能会带来有临床意义的益处。
