George Roslin Jose, Kumar Rakesh, Achenbach Sara J, Lovering Edward, Lennon Ryan J, Davis John M, Carvalho Diego Z, Crowson Cynthia S, Myasoedova Elena
Division of Rheumatology, Mayo Clinic, Rochester, MN, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
Semin Arthritis Rheum. 2025 Aug;73:152722. doi: 10.1016/j.semarthrit.2025.152722. Epub 2025 Apr 11.
BACKGROUND/OBJECTIVE: We aimed to examine the incidence of sleep disorders (SD) in individuals with rheumatoid arthritis (RA) vs. non-RA comparators, evaluate risk factors for SD, and assess the association between incident SD and dementia in RA.
This retrospective cohort study included residents aged ≥50 years within an 8-county region of Minnesota who first met the 1987 ACR criteria for RA in 1980-2014. Individuals with RA were matched 1:1 with non-RA individuals on age, sex, and calendar year of RA incidence. Data on SD, cardiovascular disease (CVD) risk factors, CVD and other comorbidities were collected from the medical records.
Nine hundred thirteen individuals with RA and 913 non-RA comparators were included (mean age: 65 years, 65 % female in both cohorts). During the median follow-up of 10.4 years in RA and 11.0 years in non-RA cohort, SD developed in 234 and 206 individuals, respectively. RA patients experienced an increased risk for any incident SD (HR 1.34; 95 % CI:1.11-1.61) and insomnia (HR 1.34; 95 % CI:1.03-1.73). Obesity, dyslipidemia, presence of CVD, depression, anxiety, and more recent calendar year of RA incidence were associated with increased risk of any SD in RA. There were no significant association between SD overall and by subtype with dementia in RA.
Individuals with RA (vs non-RA) experienced a significantly increased risk for any SD, particularly insomnia. CVD and CVD risk factors, as well as depression and anxiety increased the risk for incident SD in RA. There was no significant association between SD and dementia in RA.
背景/目的：我们旨在研究类风湿关节炎（RA）患者与非RA对照者睡眠障碍（SD）的发生率，评估SD的危险因素，并评估RA患者新发SD与痴呆之间的关联。
这项回顾性队列研究纳入了明尼苏达州8个县区域内年龄≥50岁、于1980 - 2014年首次符合1987年美国风湿病学会（ACR）RA标准的居民。RA患者在年龄、性别和RA发病日历年方面与非RA个体进行1:1匹配。从医疗记录中收集有关SD、心血管疾病（CVD）危险因素、CVD及其他合并症的数据。
纳入了913例RA患者和913例非RA对照者（平均年龄：65岁，两组队列中女性均占65%）。在RA队列中位随访10.4年、非RA队列中位随访11.0年期间，分别有234例和206例发生SD。RA患者发生任何新发SD（风险比[HR] 1.34；95%置信区间[CI]：1.11 - 1.61）和失眠（HR 1.34；95% CI：1.03 - 1.73）的风险增加。肥胖、血脂异常、CVD的存在、抑郁、焦虑以及更近的RA发病日历年与RA患者发生任何SD的风险增加相关。RA患者中SD总体及各亚型与痴呆之间均无显著关联。
RA患者（与非RA患者相比）发生任何SD的风险显著增加，尤其是失眠。CVD及CVD危险因素，以及抑郁和焦虑增加了RA患者新发SD的风险。RA患者中SD与痴呆之间无显著关联。
