Assessing Quality of Sleep in Patients with Rheumatoid Arthritis

Abstract

We sought to identify instruments assessing sleep quality that measure the domains of sleep applicable to rheumatoid arthritis (RA) patients and are feasible to use and have appropriate reliability, validity, and responsiveness properties. A systematic review of sleep instruments was conducted. In particular, domains related to sleep that were assessed in the instruments were identified and evaluated. Feasibility characteristics and psychometric properties of instruments were reviewed. At OMERACT 9, the preparatory work was described at the plenary session of the Patient Perspective Workshop, and the tasks of 3 breakout groups in ranking and scoring the domains and sleep instruments were outlined. Each breakout group considered different aspects of sleep: sleep domains, feasibility, and psychometric properties. The rapporteur for each breakout group reported back to the plenary on the domains and sleep instruments that achieved the highest rank/score. The systematic review identified 45 sleep instruments of interest. Based on these instruments, 14 domains of sleep were identified. The top ranked domains were: Sleep Adequacy (1), Sleep Maintenance (2), Sleep Initiation (3) and Daytime Functioning (4). The top ranked instruments on feasibility were: Athens Insomnia Scale (2.3), Medical Outcome Study (MOS) Sleep (4.0), Insomnia Severity Index (4.9), and Women's Health Insomnia Rating Scale (5.5). The highest scored instruments on psychometric properties were: Athens Insomnia Scale (13.6), Sleep Assessment Questionnaire (13), Pittsburgh Sleep Diary (12), and MOS Sleep (11). Sleep domains have been reviewed, and several sleep instruments have been identified. These instruments should be considered for use in planned clinical trials of RA patients to assess their applicability.

Sleep disturbance in patients with rheumatoid arthritis is related to fatigue, disease activity, and other patient-reported outcomes

“…Four sleep questionnaires have been identified as applicable for use in RA (29). In the present study with RA patients, we included the MOS sleep disturbance scale and the sleep questions from frequently used PRO questionnaires, to investigate whether there were consistent associations between the different sleep measures and other PROs.…”

“…In the context of OMERACT, four sleep questionnaires applicable for use in RA (MOS sleep measure, the Pittsburgh Sleep Diary, the Athens Insomnia Scale, and the Women's Health Insomnia Rating Scale) were found feasible, reliable, valid, and responsive (29). The MOS sleep measure scored high on truth and feasibility and was found to display good psychometric properties in assessing sleep disturbance in RA (29).…”

“…The MOS sleep measure scored high on truth and feasibility and was found to display good psychometric properties in assessing sleep disturbance in RA (29). The sleep disturbance subscale of MOS sleep was found to be valid, reliable, and sensitive to change in RA when used by Wells et al to investigate sleep quality in RA patients (20).…”

Exploring Gender Difference in Sleep Quality of Young Adults: Findings from a Large Population Study

“…It should be considered that sleep quality is a broad indicator of the adequacy of sleep, and therefore, more correctly assessed by concurrent exploration of the significant domains of sleep, such as initiation, maintenance, duration, perceived adequacy, daytime somnolence, regularity, and the use of sleep medications. 25 The results of this study suggest that validated sleep questionnaires should be used for assessing subjective aspects like sleep quality in populationbased studies.…”

Improved sleep efficiency after anti-tumor necrosis factor α therapy in rheumatoid arthritis patients

“…There is a growing recognition among clinicians of the importance of sleep in global patient care. Recently, in some RA clinical trials, a sleep assessment questionnaire has been included as an outcome measure of interest [Wells et al 2009[Wells et al , 2008.…”