Bandinelli Francesca, Delle Sedie Andrea, Mallia Ilenia, Mauro Ilaria, Pecani Nikita, Carli Linda, Esti Lorenzo, Di Carlo Marco, Carotti Marina, Salaffi Fausto
Department of Rheumatology, Santa Maria Nuova Hospital, Usl Tuscany Center, 50122 Florence, Italy.
Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
J Pers Med. 2025 Jan 17;15(1):31. doi: 10.3390/jpm15010031.
Sleep disturbance (SD) in the second half of the night due to inflammatory pain was included in the 2009 ASAS classification criteria of Spondyloarthritis (SpA), even though its definition is uncertain. We aimed to investigate SD in early-SpA (e-SpA) patients at T1 (2010-2013), comparing them to long-term SpA (l-SpA) patients at T2 (2023-2024) after at least 10 years of follow-up. At T1, in e-SpA and l-SpA cases, SD, classified as "difficulty in initiating sleep" (DIS), "difficulty in maintaining sleep" (DMS) and "early awakening" (EA), was compared to clinical parameters (ASDAS-CRP, BASDAI, m-HAQ-S, BASMI, MASES, 68/66 joint count, tenderness of sacroiliac joints, fatigue [FACIT] and HADS for anxiety [A] and depression [D]). At T2, e-SpA patients were re-evaluated using the Pittsburgh Sleep Quality Index (PSQI). At T1, 45% of 166 SpA patients had SD; in e-SpA patients (60), SD correlated with sacroiliac pain (DMS) BASDAI, FACIT and HADS-D (EA); in l-SpA patients (106), it correlated with HADS-A (DIS), BASDAI and FACIT (DMS). At T2, e-SpA patients showed a high PSQI in 51.5% of cases, correlated with T2-ASDAS-CRP and T2-BASDAI. Moreover, T1-ASDAS-CRP was predictive of T2-PSQI. SD is more specific for inflammatory pain in e-SpA and might be influenced by disease activity also in long-term disease.
尽管睡眠障碍（SD）的定义尚不明确，但因炎性疼痛导致的夜间后半段睡眠障碍已被纳入2009年脊柱关节炎（SpA）的美国风湿病学会（ASAS）分类标准。我们旨在调查早期SpA（e-SpA）患者在T1（2010 - 2013年）时的睡眠障碍情况，并将其与经过至少10年随访后的T2（2023 - 2024年）长期SpA（l-SpA）患者进行比较。在T1时，对于e-SpA和l-SpA病例，将分类为“入睡困难”（DIS）、“维持睡眠困难”（DMS）和“早醒”（EA）的睡眠障碍与临床参数（ASDAS-CRP、BASDAI、m-HAQ-S、BASMI、MASES、68/66关节计数、骶髂关节压痛、疲劳[FACIT]以及用于评估焦虑[A]和抑郁[D]的医院焦虑抑郁量表[HADS]）进行比较。在T2时，使用匹兹堡睡眠质量指数（PSQI）对e-SpA患者进行重新评估。在T1时，166例SpA患者中有45%存在睡眠障碍；在e-SpA患者（60例）中，睡眠障碍与骶髂关节疼痛（DMS）、BASDAI、FACIT以及HADS-D（EA）相关；在l-SpA患者（106例）中，它与HADS-A（DIS）、BASDAI和FACIT（DMS）相关。在T2时，51.5%的e-SpA患者PSQI得分较高，这与T2-ASDAS-CRP和T2-BASDAI相关。此外，T1-ASDAS-CRP可预测T2-PSQI。睡眠障碍在e-SpA中对炎性疼痛更具特异性，并且在长期疾病中也可能受疾病活动度影响。
