Sleep quality in patients with ankylosing spondylitis

Aydin, Ertan; Bayraktar, Kevser; Turan, Yasemın; Ömürlü, İmran Kurt; Tastaban, Engin; Şendur, Ömer Faruk

doi:10.1016/j.rbre.2014.12.007

Cited by 16 publications

(30 citation statements)

References 20 publications

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“…Gender differences were either not found [ 23 ] or not reported [ 21,25,30,32 ] in other descriptive studies within this review. In addition, some larger sample studies not included in this review do not support a marked gender difference in sleep disruption for AS populations [ 16,17 ].…”

Section: Gendermentioning

confidence: 55%

“…This finding is reflected in a strong correlation (p < 0.001) between total sleep scores and fatigue (as measured with the first question of the BASDAI) in two further selected studies [ 23,33 ]. Fatigue has been highlighted in external studies as a major symptom associated with AS, with high disease activity predicting high levels of fatigue [ 53 ].…”

Section: Fatiguementioning

confidence: 84%

“…This review shows a likely, important interrelationship between increased disturbed sleep and lower functional ability [ 21,23,29,32 ]. All these studies utilised the PSQI scale which showed significant correlations at p < 0.01.…”

Section: Functional Abilitymentioning

confidence: 91%

“…Despite this striking association, only 2 of 4 papers that investigating correlations between total sleep scores and (CRP/ESR) inflammatory blood markers [ 23,25,30,32 ] reported significant correlations [ 23,32 ] and in only one study was the effect size classified as medium strength. This may be due to the questionable validity of ESR/CRP to accurately reflect disease activity within this population [ 52 ].…”

Section: Disease Activitymentioning

confidence: 99%

“…Five studies directly compared overall sleep scores in a healthy control group with those in an AS group [ 21,23,25,30,32 ]. All of these studies found significant differences between AS patients and the control subjects.…”

Section: Prevalence Of Sleep Disturbancementioning

confidence: 99%

See 4 more Smart Citations

Prevalence and factors associated with disturbed sleep in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a systematic review

et al. 2016

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Section: Gendermentioning

confidence: 55%

Section: Fatiguementioning

confidence: 84%

Section: Functional Abilitymentioning

confidence: 91%

Section: Disease Activitymentioning

confidence: 99%

Section: Prevalence Of Sleep Disturbancementioning

confidence: 99%

See 3 more Smart Citations

Prevalence and factors associated with disturbed sleep in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a systematic review

et al. 2016

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Sleep in ankylosing spondylitis and non-radiographic axial spondyloarthritis: associations with disease activity, gender and mood

et al. 2018

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The study aims were to assess the prevalence of good or poor sleep in a cohort of axial spondyloarthritis patients and to investigate its correlation with a range of objectively and subjectively measured variables in order to develop a model for distinguishing good from poor sleepers. Five hundred ninety-eight patients with ankylosing spondylitis and 61 with non-radiographic axial spondyloarthritis completed the Jenkins Sleep Evaluation Questionnaire. Measures of disease activity, mobility, function, mood, fatigue, quality of life, work productivity, night-time pain and general health were gathered. Patients with ankylosing spondylitis or non-radiographic axial spondyloarthritis were initially compared. With the exception of waking up tired less often and having lower mobility and functioning, the two groups were similar so were combined for subsequent analysis. Twenty-nine percent of all patients were classified as good sleepers and 19% as poor sleepers. Poor sleepers had higher disease activity and fatigue scores and more night-time back pain than good sleepers. They reported poorer quality of life, general health, mood and work-related measures. A model incorporating mood, gender, fatigue and objective and subjective judgements of disease activity correctly classified 87.3% of good and poor sleepers. Poor sleep was strongly associated with poor mood, female gender, greater fatigue, greater disease activity (specifically, spinal pain and stiffness) and better mobility; however, the direction of causality between poor sleep and markers of active disease was undetermined. This study also highlights the need to standardise the measurement of sleep disturbance in axSpA to facilitate comparisons between patient groups and interventions.

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Prevalence of sleep disturbance and the association between poor disease control in people with ankylosing spondylitis within the Australian clinical setting (ASLEEP study): a real-world observational study using the OPAL dataset

Tymms¹,

Butcher

Smith³

et al. 2021

Clin Rheumatol

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Introduction Sleep disturbance and fatigue are commonly reported in ankylosing spondylitis (AS) but specific prevalence and the relationship to disease control are unknown. Method This retrospective non-interventional observational study of data from the OPAL dataset included patients with AS (ICD code M45, M45.0 or M08.1), aged 18 to 95 years and had completed ≥ 1 sleep questionnaire between 1 January 2019 and 30 September 2020. The prevalence of insomnia and obstructive sleep apnoea were assessed using the Insomnia Severity Index (ISI) and Multivariate Apnoea Prediction Index (MAPI), respectively. Propensity score (PS) matching based on sex, age and symptom duration increased comparability between patients administered tumour necrosis factor inhibitors (TNFi) and interleukin 17A inhibitors (IL-17Ai). Results Four hundred ninety-five patients were included. The mean ISI total score in the overall population was 8.6 ± 6.2. Self-reported moderate or severe clinical insomnia was present in 16% and 3.2% of patients, respectively. The mean MAPI score was 0.4 ± 0.3, self-reported apnoea was identified in 31.5% of patients and the mean FACIT-Fatigue score was 36.1 ± 10.7. In the PS matched population, the only treatment-related difference was the mean MAPI score (IL-17Ai 0.4 ± 0.3 and TNFi 0.3 ± 0.2, p = 0.046). Those with poor disease control (BASDAI ≥ 4) were more likely (odds ratio [OR] 7.29, 95% CI 2.37 to 22.46, p = 0.001) to have a greater severity of insomnia symptoms than those with good disease control. Conclusion In this real-world AS cohort, poor disease control was associated with sleep disturbance. Little difference in sleep disturbance was observed between biologic TNFi and IL-17Ai treatment. Key Points • Sleep disturbance and fatigue are common in patients with ankylosing spondylitis.• In our real-world cohort, self-reported apnoea was reported in one-third of patients; and one in five patients reported moderate to severe insomnia.• Those with poor disease control were more likely to experience greater sleep disturbance than those with good disease control.

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Sleep quality in patients with ankylosing spondylitis

Cited by 16 publications

References 20 publications

Prevalence and factors associated with disturbed sleep in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a systematic review

Prevalence and factors associated with disturbed sleep in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a systematic review

Sleep in ankylosing spondylitis and non-radiographic axial spondyloarthritis: associations with disease activity, gender and mood

Prevalence of sleep disturbance and the association between poor disease control in people with ankylosing spondylitis within the Australian clinical setting (ASLEEP study): a real-world observational study using the OPAL dataset

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