Fernando Henrique Azevedo Lopes1, Max Victor Carioca Freitas2, Veralice Meireles Sales de Bruin1, Pedro Felipe Carvalhedo de Bruin3. 1. Laboratory of Sleep and Biological Rhythms, Department of Medicine, Federal University of Ceara, Rua Prof. Costa Mendes 1608 - 4° andar, CEP 60430-971, Fortaleza, Ceara, Brazil. 2. Dr. Cesar Cals General Hospital, Fortaleza, Ceara, Brazil. 3. Laboratory of Sleep and Biological Rhythms, Department of Medicine, Federal University of Ceara, Rua Prof. Costa Mendes 1608 - 4° andar, CEP 60430-971, Fortaleza, Ceara, Brazil. pedrobruin@gmail.com.
Abstract
OBJECTIVES: To investigate the associations between sleep quality, fatigue, disease activity and depressive symptoms in women with rheumatoid arthritis (RA). METHODS: Female patients with previous diagnosis of RA from a Rheumatology Outpatient Clinic at a tertiary referral centre, in Fortaleza, Brazil, were consecutively recruited into the study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI); fatigue by the Fatigue Severity Scale (FSS); daytime sleepiness by the Epworth Sleepiness Scale (ESS); and depressive symptoms by the Beck Depression Inventory II (BDI-II). RA activity was measured by the disease activity score (DAS28). RESULTS: One hundred ten women (mean age ± SD = 51.1 ± 13.0 y) were included in the study. On average, patients with depressive symptoms (BDI-II > 13), as compared to those without, showed poorer sleep quality (PSQI: 10.09 ± 4.1 vs 7.33 ± 3.55; p = 0.001 respectively), more fatigue (FSS: 4.69 ± 1.89 vs 3.34 ± 1.8; p = 0.001) and higher disease activity level (DAS28: 4.36 ± 1.53 vs 3.7 ± 1.39; p = 0,047). The logistic regression analysis showed that sleep quality is an independent predictor of depressive symptom severity. CONCLUSION: Depressive symptoms, impaired sleep and fatigue are common in women with RA. Poor sleep is associated with greater frequency and severity of depressive symptoms in these patients, suggesting that screening for sleep and mood problems may be relevant both in clinical research and routine patient care. Future studies investigating the impact of measures to promote healthy sleep on depressive symptom control in this patient population are warranted.
OBJECTIVES: To investigate the associations between sleep quality, fatigue, disease activity and depressive symptoms in women with rheumatoid arthritis (RA). METHODS: Female patients with previous diagnosis of RA from a Rheumatology Outpatient Clinic at a tertiary referral centre, in Fortaleza, Brazil, were consecutively recruited into the study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI); fatigue by the Fatigue Severity Scale (FSS); daytime sleepiness by the Epworth Sleepiness Scale (ESS); and depressive symptoms by the Beck Depression Inventory II (BDI-II). RA activity was measured by the disease activity score (DAS28). RESULTS: One hundred ten women (mean age ± SD = 51.1 ± 13.0 y) were included in the study. On average, patients with depressive symptoms (BDI-II > 13), as compared to those without, showed poorer sleep quality (PSQI: 10.09 ± 4.1 vs 7.33 ± 3.55; p = 0.001 respectively), more fatigue (FSS: 4.69 ± 1.89 vs 3.34 ± 1.8; p = 0.001) and higher disease activity level (DAS28: 4.36 ± 1.53 vs 3.7 ± 1.39; p = 0,047). The logistic regression analysis showed that sleep quality is an independent predictor of depressive symptom severity. CONCLUSION: Depressive symptoms, impaired sleep and fatigue are common in women with RA. Poor sleep is associated with greater frequency and severity of depressive symptoms in these patients, suggesting that screening for sleep and mood problems may be relevant both in clinical research and routine patient care. Future studies investigating the impact of measures to promote healthy sleep on depressive symptom control in this patient population are warranted.
Authors: Y Zyrianova; B D Kelly; C Gallagher; C McCarthy; M G Molloy; J Sheehan; T G Dinan Journal: Ir J Med Sci Date: 2006 Apr-Jun Impact factor: 1.568
Authors: A J Ferrari; A J Somerville; A J Baxter; R Norman; S B Patten; T Vos; H A Whiteford Journal: Psychol Med Date: 2012-07-25 Impact factor: 7.723
Authors: Damian Hoy; Lyn March; Peter Brooks; Fiona Blyth; Anthony Woolf; Christopher Bain; Gail Williams; Emma Smith; Theo Vos; Jan Barendregt; Chris Murray; Roy Burstein; Rachelle Buchbinder Journal: Ann Rheum Dis Date: 2014-03-24 Impact factor: 19.103