Do sleepy rheumatoid arthritis patients have a sleep disorder?

Abstract

OBJECTIVE:

Subjective reports of sleep dysfunction are common in people with rheumatoid arthritis (RA). Our objective was to determine whether excess sleepiness in RA is associated with polysomnographic (PSG) abnormalities.

METHODS:

Twelve RA participants with abnormal sleep scores were identified in clinic and age/gender matched to RA participants with normal Epworth Sleepiness Scale (ESS) scores. A total of 25 participants were recruited. All participants underwent overnight PSG studies with measurement of apnoea-hypopnoea indexes (AHI). Questionnaire instruments, including the ESS, Berlin questionnaire for sleep apnoea risk, visual analogue scale for fatigue, modified Health Assessment Questionnaire (mHAQ) and the Center for Epidemiologic Studies - Depression (CES-D) score, along with RA assessments, were reapplied on the PSG study night.

RESULTS:

Seven men and 18 women participated. Ten participants had abnormal ESS scores and 15 had normal ESS scores on the PSG night. PSG data revealed that 68% of patients had abnormal AHI (≥ 5). Abnormal ESS (> 10) had an 80% positive predictive value (PPV) for abnormal AHI; the negative predictive value (NPV) of normal ESS was 40%. By contrast, high-risk categorization for obstructive sleep apnoea (OSA) by the Berlin questionnaire had a PPV of 77.8%, and for low-risk status, an NPV of 37.5%.

CONCLUSIONS:

In the present study population, there was a high prevalence of abnormal AHI consistent with OSA. An abnormal ESS had high positive predictive value for an abnormal AHI.

• Authors: John A Gjevre, Regina M Taylor-Gjevre, Bindu V Nair, Hyun J Lim
• Journal: Musculoskeletal care (Musculoskeletal Care) Vol. 10 Issue 4 Pg. 187-95 (Dec 2012) ISSN: 1557-0681 [Electronic] England
• PMID: 22577060 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 John Wiley & Sons, Ltd.

Topics

• Adult
• Arthritis, Rheumatoid (epidemiology)
• Case-Control Studies
• Comorbidity
• Female
• Health Status Indicators
• Humans
• Male
• Middle Aged
• Polysomnography
• Predictive Value of Tests
• Quality of Life
• Sleep Wake Disorders (epidemiology)