The Impact of Sleep Problems on Rheumatoid Arthritis Disease Activity

Background and Objective Sleep difficulties tend to be more prevalent in rheumatoid arthritis (RA) patients than in the general population. Patients’ mental, physiological, and life quality are all dependent on receiving good quality sleep. In practice, RA is managed not only by rheumatologists but also by a variety of other specialists. To assess subjective sleep quality in RA patients and its relationship to disease activity, pain intensity, and psychological state.Methods Three hundred RA patients participated in a cross-sectional study in which they were evaluated clinically and underwent the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II, and Disease Activity Score-28 with erythrocyte sedimentation rate (DAS28-ESR). Two groups of RA patients were created based on the PSQI score. Group 1 included RA patients with good sleep, and Group 2 included RA patients with poor sleep.Results The study included 276 females and 24 males, with a mean age of 38.5 ± 8.8 years and a disease duration of 4.3 ± 3.8 years. Sleep disturbances were found in 65.3% of our RA patients, with habitual sleep efficiency being the most commonly affected component (50%), and 91% of the patients studied did not take any sleep medication. Poor sleep was linked to increased DAS28, pain, and different degrees of depressive symptoms. All PSQI components and total PSQI scores showed a significant correlation with pain and depressive symptom severity scores. However, no correlation was found with disease duration or erosive joint changes.Conclusions Patients with RA frequently encounter sleep problems. Individuals with RA exhibiting poor sleep quality are more likely to encounter varying degrees of depressive symptoms, disease activity flares, and more intense pain. This issue, as well as its expected consequences for RA disease parameters, should be recognized.