Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Feb 15;7(1):49-55.

Sleep quality and functional disability in patients with rheumatoid arthritis

Faith S Luyster  1 , Eileen R Chasens, Mary Chester M Wasko, Jacqueline Dunbar-Jacob
Affiliations

Sleep quality and functional disability in patients with rheumatoid arthritis

Faith S Luyster et al. J Clin Sleep Med. .

Abstract

Study objectives: Disturbed sleep is a common complaint in patients with rheumatoid arthritis (RA). The majority of the research investigating relationships between sleep and patient-reported outcomes in RA has focused on pain and depression. Poor sleep may also affect disability, though this association has not been explored in RA. The present study represents a cross-sectional examination of the relationship between sleep quality and functional disability in 162 patients with RA. Depression, pain severity, and fatigue were examined as separate mediators of the relationship between sleep quality and disability.

Methods: The sample had an average age of 58.47 years, and 76% were female. Participants completed the following questionnaires as part of a medication adherence intervention study: Pittsburgh Sleep Quality Index, Beck Depression Inventory-II, Medical Outcomes Study Short Form-36, and the Health Assessment Questionnaire.

Results: Poor sleep quality was significantly correlated with higher levels of depressive symptoms, greater pain severity, increased fatigue, and greater functional disability. Hierarchical regression analyses showed that sleep quality was not associated with functional disability when depression, pain severity, and fatigue were entered into the model. Separate mediation analyses of depression, pain severity, and fatigue revealed that pain severity and fatigue were mediators of the relationship between sleep quality and disability.

Conclusions: Sleep quality has an indirect effect on functional disability through its relationship with pain severity and fatigue. Future research should investigate whether improvements in sleep can reduce disability in patients with RA.

Keywords: Sleep quality; depression; disability; fatigue; pain; rheumatoid arthritis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Pain severity and fatigue as mediators of the relationship between sleep quality and functional disability The direct association between sleep quality and functional disability was no longer significant after accounting for the effects of depression, pain severity, and fatigue (from β = 0.30, p < 0.001 to β = 0.10, ns). **p < 0.01, ***p < 0.001
See this image and copyright information in PMC

References

    1. Kirwan J, Heiberg T, Hewlett S, et al. Outcomes from the patient perspective workshop at OMERACT 6. J Rheumatol. 2003;30:868–72. - PubMed
    1. Hirsch M, Carlander B, Verge M, et al. Objective and subjective sleep disturbances in patients with rheumatoid arthritis: a reappraisal. Arthritis Rheum. 1994;37:41–9. - PubMed
    1. Wolfe F, Michaud K, Li T. Sleep disturbance in patients with rheumatoid arthritis: evaluation by medical outcomes study and visual analog sleep scales. J Rheumatol. 2006;33:1942–51. - PubMed
    1. Lavie P, Epstein R, Tzischinsky O, et al. Actigraphic measurements of sleep in rheumatoid arthritis: comparison of patients with low back pain and healthy controls. J Rheumatol. 1992;19:362–5. - PubMed
    1. Mahowald MW, Mahowald ML, Bundlie SR, Ytterberg SR. Sleep fragmentation in rheumatoid arthritis. Arthritis Rheum. 1989;32:974–83. - PubMed

Publication types

MeSH terms

LinkOut - more resources