OBJECTIVE: To examine the associations between arthritis and insomnia symptoms and unrefreshing sleep, as well as the role of pain as a mediator of these relationships. METHODS: Analyses were conducted on the cross-sectional, nationally representative, weighted sample of adults > or =18 years of age (n = 118,336) in the 2000/2001 Canadian Community Health Survey. Four logistic regression models were estimated for each sleep problem (model 1: arthritis only; model 2: model 1 + sociodemographic characteristics, lifestyle factors, and other chronic conditions; model 3: model 2 + mental health [stress, depression]; and model 4: model 3 + pain). Mediation by pain was quantified by the percentage change in the effect of arthritis on a particular sleep problem by comparing models 3 and 4. RESULTS: The prevalence of insomnia symptoms and unrefreshing sleep in persons with arthritis was 24.8% and 11.9%, respectively. These estimates are twice as high as those for persons without arthritis. In multivariate regression analyses, the addition of pain decreased the effect of arthritis by 53% (insomnia symptoms) and 64% (unrefreshing sleep). The effect of arthritis was still statistically significant in these models, suggesting that pain is a partial mediator of these relationships. CONCLUSION: Insomnia symptoms and unrefreshing sleep affect a considerable proportion of individuals with arthritis. Pain mediates a substantial amount of the relationship between arthritis and sleep problems. Better pain management could significantly improve sleep in individuals with arthritis.
OBJECTIVE: To examine the associations between arthritis and insomnia symptoms and unrefreshing sleep, as well as the role of pain as a mediator of these relationships. METHODS: Analyses were conducted on the cross-sectional, nationally representative, weighted sample of adults > or =18 years of age (n = 118,336) in the 2000/2001 Canadian Community Health Survey. Four logistic regression models were estimated for each sleep problem (model 1: arthritis only; model 2: model 1 + sociodemographic characteristics, lifestyle factors, and other chronic conditions; model 3: model 2 + mental health [stress, depression]; and model 4: model 3 + pain). Mediation by pain was quantified by the percentage change in the effect of arthritis on a particular sleep problem by comparing models 3 and 4. RESULTS: The prevalence of insomnia symptoms and unrefreshing sleep in persons with arthritis was 24.8% and 11.9%, respectively. These estimates are twice as high as those for persons without arthritis. In multivariate regression analyses, the addition of pain decreased the effect of arthritis by 53% (insomnia symptoms) and 64% (unrefreshing sleep). The effect of arthritis was still statistically significant in these models, suggesting that pain is a partial mediator of these relationships. CONCLUSION:Insomnia symptoms and unrefreshing sleep affect a considerable proportion of individuals with arthritis. Pain mediates a substantial amount of the relationship between arthritis and sleep problems. Better pain management could significantly improve sleep in individuals with arthritis.
Authors: Grant H Louie; Maria G Tektonidou; Alberto J Caban-Martinez; Michael M Ward Journal: Arthritis Care Res (Hoboken) Date: 2011-02 Impact factor: 4.794
Authors: G A Hawker; A M Davis; M R French; J Cibere; J M Jordan; L March; M Suarez-Almazor; J N Katz; P Dieppe Journal: Osteoarthritis Cartilage Date: 2008-04 Impact factor: 6.576
Authors: K Løppenthin; B A Esbensen; P Jennum; M Østergaard; A Tolver; T Thomsen; J Midtgaard Journal: Clin Rheumatol Date: 2015-01-27 Impact factor: 2.980
Authors: Patrick H Finan; Luis F Buenaver; Sara C Bounds; Shahid Hussain; Raymond J Park; Uzma J Haque; Claudia M Campbell; Jennifer A Haythornthwaite; Robert R Edwards; Michael T Smith Journal: Arthritis Rheum Date: 2013-02