Sleep Quality Among Patients with Rheumatoid Arthritis and it’s Correlation with Disease Activity and Duration at Baghdad Teaching Hospital

Abstract

Rheumatoid arthritis (RA) is a common chronic, progressive, autoimmune disease characterized by debilitating articular and extra articular manifestations. Sleep quality is defined as one’s satisfaction with the sleep experience, integrating aspects of sleep initiation, sleep maintenance, sleep quantity, and refreshment upon awakening. To assess sleep quality in a sample of rheumatoid arthritis patients and compare it with healthy individuals, as well as it’s a correlation to rheumatoid arthritis disease activity and duration. A case-control study was conducted at Baghdad Teaching Hospital, Rheumatology Unit during the period from September 2017 to August 2018. The study was included 100 Rheumatoid Arthritis patients who met the inclusion criteria, and 100 healthy individuals as a control, data were collected using a preconstructed data collection sheet. Questionnaires included demographic and clinical data of the patients and controls. Rheumatoid Arthritis was diagnosed with 2010 ACR/EULAR Classifications Criteria for RA (by Consultant Rheumatologist), sleep quality assessed by using The Pittsburgh Sleep Quality Index (PSQI). The mean age of the studied groups was 48.1±11.1 years and 46.3±10.0 years in rheumatoid arthritis and control groups, respectively. no statistically significant differences between both groups had been found in age, gender, BMI and other demographic variables (P value >0.05). Except for the Family history of RA was significantly higher in RA patients than controls. Poor sleep quality was found in 74% of patients with rheumatoid arthritis, while seen in 46% of controls. In the rheumatoid arthritis group, disease duration and Clinical Disease Activity Index (CDAI) was significantly and directly (positively) correlated with the global PSQI. Patients with poor sleep quality had significantly longer disease duration (mean duration=12.6 years) than those with good sleep quality (mean duration= 6.1 years). Similarly, RA patients with poor sleep quality had significantly higher CDAI (mean CDAI=20.7) than those with good sleep quality (mean CDAI=11.6). Poor sleep quality observed in 74% of Iraqi rheumatoid arthritis patients in comparison to 46% of control sleep quality positively correlated with clinical disease activity and duration of rheumatoid arthritis.