Fatigue and sleep in children and adolescents with juvenile idiopathic arthritis:a cross-sectional study

Abstract

Background/aim The aims of this study were to primarily investigate fatigue and sleep and to secondarily examine possible relationships between disease activity, pain, and functional ability in children and adolescents with juvenile idiopathic arthritis (JIA). Materials and methods Ninety-six patients were enrolled in the study. Disease activity, functional ability, fatigue symptoms, fatigue severity, and sleep quality were assessed with the Juvenile Arthritis Disease Activity Score (JADAS), Childhood Health Assessment Questionnaire (CHAQ), Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale (PedsQL-F), visual analog scale (VAS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Results Fatigue severity was moderate to high in 75% of patients with JIA and sleep quality was poor in 40% of them. VAS-fatigue was correlated with VAS-pain, VAS-wellbeing, PSQI, and sleep duration (P < 0.001). Significant relationships were found between the PedsQL-F and all other parameters except JADAS (P < 0.05). VAS-fatigue, CHAQ, and PSQI were identified as significant predictors of PedsQL-F (P < 0.05). Sleep quality, pain, and sleep duration were also significant predictors of fatigue severity (P < 0.05). Conclusion This study suggests that fatigue and sleep problems are common problems in JIA. If underlying factors of fatigue and sleep are understood, strategies for improving sleep/fatigue paradox may develop in JIA.

Increased frequency of sleep problems in children and adolescents with familial Mediterranean fever: The role of anxiety and depression

“…A study shows there is a weak correlation between pain and sleep, 31 whereas no correlation was found between pain and total score and subscales of the CSHQ in patients with JIA in another study 32 . In a study with children with JIA, those with poor sleep quality had higher pain and fatigue scores and poor quality of life 33 . In our study, there was no difference in sleep problems, depression, and anxiety between the patients with and without exertional leg pain.…”

“…32 In a study with children with JIA, those with poor sleep quality had higher pain and fatigue scores and poor quality of life. 33 In our study, there was no difference in sleep problems, depression, and anxiety between the patients with and without exertional leg pain. However, in a study conducted with FMF patients, it was concluded that patients who faced exertional leg pain had a higher sleeping score compared to healthy individuals and patients who did not have pain.…”

Reducing fatigue in pediatric rheumatic conditions: a systematic review

“…Identification of possible underlying biological and psychosocial mechanisms as possible treatment targets to reduce complaints of fatigue in children and adolescents with PRCs is warranted. Future studies should investigate interventions applying a multifactorial approach of fatigue, and therefore be aimed at the physical and psychosocial dimensions to fatigue, combined with an assessment to determine fatigue in relation to physical, environmental, and personal outcome parameters [ 6 , 10 , 15 ].…”

“…Fatigue has been described as a multidimensional concept and is a subjective symptom in which perceived severity may be related to both psychosocial and disease- and treatment-related factors [ 8 ]. Several studies have suggested a relation of fatigue with pain, health-related quality of life (HRQoL), physical activity, medication, stress, mood, sleep dysregulation, increased school absences, and increased disease activity [ 1 , 6 , 8 – 10 ]. Most clinicians assume that fatigue is caused primarily by drugs such as Methotrexate or disease activity and inflammation in PRCs [ 9 , 11 ].…”

“…Most clinicians assume that fatigue is caused primarily by drugs such as Methotrexate or disease activity and inflammation in PRCs [ 9 , 11 ]. However, fatigue can also persist in children independent of their disease-activity levels [ 1 , 6 , 10 ]. Apparently, fatigue can be better explained by transdiagnostic psychosocial factors – e.g.…”