Associação entre sintomas de insônia e artrite reumatóide em idosos

Abstract

INTRODUCTIONThe aging of the population is a worldwide phenomenon, highlighting the significant increase in the population aged 70 years and older. In 2009, the results of the National Household Sample Survey indicated a total of 11.3 million in this age group. The decrease of the children and youth and the consequent increase in adult population and elderly is related to the continued decline in the fertility and mortality rate combined with an increased life expectancy (1) .Simultaneously, the most prevalent diseases among elderly are also changing, with a sharp decline in the morbidity and mortality from infectious and contagious diseases and an increase in chronic non-communicable diseases (CNCDs) (2) . With aging, the probability of acquiring CNCD increases while functional capacity and body reserves decrease, leading to a greater susceptibility to these diseases and other health problems (3) . Thus, there may be a direct association between the demographic and epidemiological transition.According to the Brazilian Institute of Geography and Statistics, in 2008, the most prevalent diseases in seniors were: high blood pressure (53.3%), back pain (35.1%), rheumatoid arthritis or rheumatism (24.2%), heart diseases (17.3%), diabetes mellitus (16.1%) and other diseases (20.9%) (1) . The CNCDs may result in losses in the overall health and functionality of the elderly, negatively affecting their quality of life, including the standard and quality of sleep (4) .Aging by itself can bring changes in the usual pattern of sleep, such as quantitative reduction of deep sleep stages and increase in the light sleep stages, nocturnal sleep disruption, increased sleep onset latency, reduced duration of nocturnal sleep, and more frequent transitions between the sleep stages during the night. The prevalence of sleep-disordered breathing and disorders related to increased nocturnal myoclonic activity are also more common over 60 years of age, so that the complaints of insomnia symptoms are most frequent among the elderly (4)(5) .There are four essential symptoms for the diagnosis of sleep disorders and insomnia: difficulty falling asleep, difficulty staying asleep, early awakening and non-restorative sleep. Various international classification manuals for sleep disorders shared these criteria, including the Research Diagnostic Criteria of the American Academy of Sleep Medicine (RDC), the International Classification of Sleep Disorders (ICSD-2) and the International Classification of Diseases Organization of the World Health Organization (ICD 10) (6) .Changes in sleep patterns and insomnia symptoms in seniors may occur as a consequence of CNCDs. Other prevalent diseases in this age group may influence sleep quality, among them, we highlight depression, bladder weakness and neurological problems, such as Parkinson's disease and stroke (7)(8) . In addition, lifestyles changes that are often linked to aging, such as retirement and widowhood, may contribute to these sleep modifications (9) .Among the examples of CNCDs, rheumatoid ar...

<p>Frequency of sleep disorders in patients with rheumatoid arthritis</p>

“…Furthermore, this percentage is higher than the globally reported percentage among RA patients. Freitas et al3 used the Nottingham Health Profile and revealed that 55% of rheumatoid patients suffered from insomnia. This finding was explained by pain, functional disability, and depression.…”

“…Poor sleep quality has been linked to pain, mood, fatigability, stress, and disease activity in the rheumatic disease population 1. Various primary sleep disorders have been observed in RA, including a high prevalence of obstructive sleep apnea (OSA),2 insomnia,3 and restless legs syndrome (RLS) 4. Abbasi et al5 determined that the frequency of sleep disorders among 100 RA patients is 72%.…”

“…In another study, chronic insomnia was assessed in a cross-sectional multicenter survey of 689 subjects with RA in Brazil. The results showed that elderly subjects with RA had a 1.6-fold increased risk of experiencing insomnia symptoms compared to subjects without RA 3. Moreover, Purabdollah et al7 studied the effects of variable sleep disorders on the quality of life in 210 patients with RA and concluded that sleep disorders and pain are associated with a poor quality of life in patients with RA.…”

Diagnósticos de enfermagem relacionados aos distúrbios do sono em idosos em serviço geriátrico

“…Convém destacar que outras características definidoras autorreferidas foram expressas pelos idosos, a exemplo de: sono não restaurador, redução na qualidade de vida, insatisfação com o sono, alteração no afeto, no humor e na concentração, estado de saúde comprometido e energia insuficiente. Tais características corroboram outros estudos e são responsáveis por grande insatisfação, além de prejudicar a saúde física, cognitiva e a qualidade de vida, principalmente, quando esses problemas estão associados às doenças, implicando negativamente na saúde das pessoas, especialmente das idosas [11].…”

Rheumatoid Arthritis (RA): Implications in people’s loss of function

“…Those expenses come from long term pharmacologic treatments, surgeries, physical rehabilitation, the loss of work days, both patients' and family members' who have to keep them company, and even from early retirements due to the patients' incapacity to fulfill their jobs' demands. Freitas et al (2013) state that pain and discomfort caused by RA can lead to serious consequences to the patients since they both contribute to the loss of functionality, and bad sleep quality, they undermine the patients' social participation, they have an important negative impact on people's health and well-being, especially when these people are older.…”