Sleep disturbance and quality of life in Rheumatoid Arthritis: a prospective mobile health study (Preprint)

2021 ◽  
Author(s):  
John McBeth ◽  
William G Dixon ◽  
Susan Mary Moore ◽  
Bruce Hellman ◽  
Ben James ◽  
...  

BACKGROUND Sleep disturbance and poor health related quality of life (HRQoL) are common in people with rheumatoid arthritis (RA). Sleep disturbances, such as less total sleep time, more waking periods after sleep onset, and higher levels of non-restorative sleep, may be a driver of HRQoL. However, understanding if these sleep disturbances reduce HRQoL has, to date, been challenging due to the need to collect complex time-varying data in high resolution. Such data collection has now been made possible by the widespread availability and use of mobile health (mHealth) technologies. OBJECTIVE In a mobile health (mHealth) study we tested whether sleep disturbance (both absolute values and variability) caused poor HRQoL. METHODS The Quality of life, sleep and rheumatoid arthritis (QUASAR) study was a prospective mHealth study of adults with RA. Participants completed a baseline questionnaire, and for 30 days wore a triaxial accelerometer to objectively assess sleep, and provided daily reports via a smartphone app of sleep (Consensus Sleep Diary (CSD)), pain, fatigue, mood, and other symptoms. Participants completed the World Health Organization Quality of Life-Brief (WHOQoL-BREF) questionnaire every 10 days. Multi-level modelling tested the relationship between sleep variables and WHOQoL-BREF domains (physical, psychological, environment and social). RESULTS Of 268 recruited participants, 254 were included in this analysis. Across all WHOQoL-BREF domains, participant’s scores were lower than the population average. CSD sleep parameters predicted WHOQoL-BREF domain scores. For example, for each hour increase in the total time asleep physical domain scores increased by 1.11 points (β = 1.11 (0.07, 2.15)) and social domain scores increased by 1.65 points. These associations were not explained by sociodemographic and lifestyle factors, disease activity, medication use, levels of anxiety, sleep quality, or clinical sleep disorders. They were, however, attenuated and no longer significant when pain, fatigue and mood were included in the model. Increased variability in the total time asleep, was associated with poorer physical and psychological domain scores independently of all covariates. There were no patterns of association between actigraphy measured sleep and WHOQoL-BREF. CONCLUSIONS Optimising total sleep time, increasing sleep efficiency, decreasing sleep onset latency, and reducing the variability in total sleep time could improve HRQoL in people with RA.

1995 ◽  
Vol 10 (S3) ◽  
pp. 99s-102s ◽  
Author(s):  
D Léger ◽  
C Janus ◽  
A Pellois ◽  
MA Quera-Salva ◽  
JP Dreyfus

SummaryFrom 20,000 households regularly surveyed by a national survey institute (Sofres), two groups were selected and questioned (using a 23-item questionnaire) about sleep vigilance and quality of life. The first group was composed of insomniacs using zopiclone for the last 12 months and no other CNS treatments (167 subjects). The second group was composed of 381 “good sleepers” selected as having no or occasionally one sleep disturbance in the last 12 months. No difference was found between the two groups in average total sleep time. Sleep disturbances were statistically equal in the two groups except for difficulties in initiating sleep which is more present for zopiclone users (13% vs 3%). Vigilance was mostly comparable in both groups.Five aspects of quality of life explored by the questionnaires (the professional, relational and sentimental, domestic, leisure and safety aspects) appeared to be comparable in the two groups.


Author(s):  
John McBeth ◽  
William G Dixon ◽  
Susan Mary Moore ◽  
Bruce Hellman ◽  
Ben James ◽  
...  

Author(s):  
Ganesh Ingole ◽  
Harpreet S. Dhillon ◽  
Bhupendra Yadav

Background: A prospective cohort study to correlate perceived sleep disturbances in depressed patients with objective changes in sleep architecture using polysomnography (PSG) before and after antidepressant therapy.Methods: Patients were recruited into the study after applying strict inclusion and exclusion criterion to rule out other comorbidities which could influence sleep. A diagnosis of Depressive episode was made based on ICD-10 DCR. Psychometry, in the form of Beck Depressive inventory (BDI) and HAMD (Hamilton depression rating scale) insomnia subscale was applied on Day 1 of admission. Patients were subjected to sleep study on Day 03 of admission with Polysomnography. Patients were started on antidepressant treatment post Polysomnography. An adequate trial of antidepressants for 08 weeks was administered and BDI score ≤09 was taken as remission. Polysomnography was repeated post remission. Statistical analysis was performed using Kruskal Wallis test and Pearson correlation coefficient.Results: The results showed positive (improvement) polysomnographic findings in terms of total sleep time, sleep efficiency, wake after sleep onset, percentage wake time and these findings were statistically significant. HAM-D Insomnia subscale was found to correlate with total sleep time, sleep efficiency, wake after sleep onset, total wake time and N2 Stage percentage.Conclusions: Antidepressant treatment effectively improves sleep architecture in Depressive disorder and HAM-D Insomnia subscale correlates with objective findings of total sleep time, sleep efficiency, wake after sleep onset, total wake time and duration of N2 stage of NREM.


2020 ◽  
Vol I (2) ◽  
pp. 29-32
Author(s):  
Pavan Deepak

Sleep plays a pivotal role in maintaining homeostasis and one of a few foremost determinants of Quality of Life. Quality of life is a well-studied topic in oncology and various measures are taken to improve quality of life in this setting, in order to achieve therapeutic outcome and compliance in general in cancer patients. Sleep disturbances and disruption in circadian rhythm is among a few common presenting complaints of patients with malignancy and affects between 30% to 75% of newly diagnosed or recently treated cancer patients,1 which are reported as double that of the general population, paving the way for decreased compliance and inefficacy of therapy and pose as a detriment to general well-being, and quality of life. It is evident that mood disorders and sleep disturbances are more prevalent in females (1.3 to 1.8 times more than men),2 one may theorize that the prevalence of sleep disturbance in gynaecologic malignancies is greater than that of general population. Sleep disturbances in gynaecologic cancer patients often include difficulty in initiation of sleep, frequent awakening, difficulty in staying asleep, and restless leg syndrome. Systematic research on various sleeps disorders and their therapeutic approach in gynaecologic cancers in general is lacking. This article aims at elucidating and giving overview of sleep pattern changes in gynaecologic malignancies and therapeutic approaches to foster better sleep in this subset of population. This article also emphasizes the need to envisage the treatment strategies targeting cytokines and cortisol in improvement of sleep parameters in gynaecologic malignancies.


Author(s):  
Bruce Rohrs ◽  
Benjamen Gangewere ◽  
Alicia Kaplan ◽  
Amit Chopra

Despite its common comorbidity, sleep disturbance is often underrecognized and undertreated in individuals with anxiety disorders. Compared to mood disorders, sleep disturbance in this population is less well studied except for panic disorder and generalized anxiety disorder. Some evidence suggests a bidirectional link between anxiety disorders and sleep disturbance. Polysomnography findings point to some commonalities across anxiety disorders, including longer sleep onset latency, reduced total sleep time, and reduced sleep efficiency. The underlying biological mechanisms linking anxiety disorders and sleep disturbance are still unclear. However, there is limited evidence suggesting a connection between impaired executive functioning due to sleep problems and failure to inhibit anxiety related thoughts and feelings. Cortisol irregularities and disruption in the serotonergic system may also play a role. Evidence suggests that anxiety sensitivity is a transdiagnostic factor that contributes to both anxiety disorders and sleep disturbance. Further research is warranted to elucidate common biological and psychological factors underlying sleep disturbances and anxiety disorders. There is an imminent need to systematically assess the impact of sleep disturbance on symptom severity and treatment outcomes in anxiety, obsessive-compulsive, and related disorders. Limited evidence is available for medications and targeted psychotherapeutic interventions for management of sleep disturbance thus warranting the development of robust sleep interventions to achieve optimal clinical outcomes in this patient population.


2020 ◽  
Vol 36 (1) ◽  
pp. 9-21
Author(s):  
Marek Jarema ◽  
Adam Wichniak

Insomnia is an important medical problem; its treatment requires both nonpharmacological methods (education and psychotherapy) and the use of hypnotic agents. The benzodiazepine derivatives may be used as hypnotic agents but their use is substantially limited. The alter­native treatment includes so-called z-drugs, which means nonbenzodiazepine hypnotic agents. Their mechanism of pharmacological action is a GABA-receptor agonism. In general, these drugs improve the quality of sleep (sleep latency, wake after sleep onset, number and duration of awakenings, total sleep time). Contrary to the benzo­diazepines they do not possess anti-anxiety, myorelaxant, and anti-seizure properties, and are better tolerated. Eszopiclone for the treatment of insomnia was not available in Poland. It is not only effective in the treatment of insomnia in comparison to placebo but is also well tolerated. It may be used for a longer time than the benzodiazepines – not only a couple of weeks but per several months. Eszopiclone shortens the sleep latency, decreases the number of wakes after sleep onset and increases total sleep time. It improves the subjective evaluation of sleep by the patients, the quality of sleep and functioning during the day. Its efficacy in the treatment of insomnia in the elderly has also been proved. It is quite well-tolerated and the most frequent side-effect of eszopiclone in the unpleasant taste.


2006 ◽  
Vol 7 (3) ◽  
pp. 293-296 ◽  
Author(s):  
Debora Fernandes de Melo Vitorino ◽  
Luciane Bizari Coin de Carvalho ◽  
Gilmar Fernandes do Prado

2021 ◽  
Vol 38 (4) ◽  
pp. 275-281 ◽  
Author(s):  
Wan Seok Seo

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by abnormalities in social communication/interaction and restrictive, repetitive patterns of behavior. ASD is a relatively common psychiatric disorder, with a prevalence of approximately 1.7% in children. Although many children and adolescents with ASD visit the hospital for medical help for emotional and behavioral problems such as mood instability and self-harming behavior, there are also many visits for sleep disturbances such as insomnia and sleep resistance. Sleep disturbances are likely to increase fatigue and daytime sleepiness, impaired concentration, negatively impact on daytime functioning, and pose challenges in controlling anger and aggressive behavior. Sleep disturbance in children and adolescents with ASD negatively affects the quality of life, nothing to say the quality of life of their families and school members. In this review, sleep disturbances that are common in children and adolescents with ASD and adolescents are presented. The developmental and behavioral impacts of sleep disturbances in ASD were also considered. Finally, non-pharmacological and pharmacological treatments for sleep disturbances in children and adolescents with ASD and adolescents are reviewed.


Author(s):  
Elisaveta Sokolov ◽  
K. Ray Chaudhuri

Disturbances in nocturnal sleep and their consequences during waking in Parkinson disease (PD) were recognized in 1817 by James Parkinson, who described sleep problems in his case series as follows: “His attendants observed, that of late the trembling would sometimes begin in his sleep, and increase until it awakened him: when he always was in a state of agitation and alarm.” Sleep disturbance in PD is complex, with a prevalence of up to 98%, and has been shown to be a key determinant of quality of life. Sleep disturbances in PD are heterogeneous, ranging from insomnia to drug-induced sleep disorders, and now can be assessed by simple validated bedside tools such as the Parkinson’s Disease Sleep Scale (PDSS). Also, sleep, contrary to previous perceptions, can be disordered not just in advanced PD, but also in the pre-motor as well as the untreated states.


2016 ◽  
Vol 39 (4) ◽  
pp. 492-506 ◽  
Author(s):  
Sami Y. Al-Rawashdeh ◽  
Terry A. Lennie ◽  
Misook L. Chung

Sleep disturbance is common in patients with heart failure and their family caregivers. The purpose of this study was to determine whether sleep disturbances of patients and their spousal caregivers predicted their own and their partners’ quality of life (QoL) in 78 heart failure patient–spousal caregiver dyads. Sleep disturbance was assessed using a composite score of four common sleep complaints. QoL was assessed by the physical and mental well-being subscales of the Short-Form 12 Health Survey. The multilevel dyadic actor–partner interdependence model analysis was used to determine the association between sleep disturbance and QoL. Each individual’s sleep disturbance predicted their own poor physical and mental well-being while spousal caregivers’ sleep disturbance predicted their partners’ mental well-being. Results indicated that patients’ mental well-being is sensitive to their spouses’ sleep disturbance. Interventions targeting improving sleep and QoL may have to include both patients and spousal caregivers.


Sign in / Sign up

Export Citation Format

Share Document