Background
Methods
Participants
Demographics and clinical characteristics
Assessment of psychological parameters
Assessment of self-reported life quality
Assessment of self-reported sleep quality
Data collection
Data analysis
Results
Patient characteristics
Variables | Cases (n = 131) | Controls (n = 104) |
p
|
---|---|---|---|
Gender, female, N (%) | 112 (85.5) | 88 (84.6) | 0.79 |
BMI (kg/m2), Mean ± SD | 22.5 ± 3.12 | 22.84 ± 2.81 | 0.432 |
Age (years), Mean ± SD | 54.5 ± 11.5 | 54.77 ± 11.20 | 0.851 |
Monthly income (yuan), N (%) | 0.973 | ||
<1000 | 67 (51.1) | 55 (52.9) | |
1000-3000 | 47 (35.9) | 35 (33.7) | |
3000-5000 | 13 (9.9) | 10 (9.6) | |
>5000 | 4 (3.1) | 4 (3.8) | |
Marital status, N (%) | 0.411 | ||
Single | 7 (5.3) | 11 (10.6) | |
Married | 118 (90.1) | 90 (86.5) | |
Divorced | 1 (0.8) | 1 (1.0) | |
Widowed | 5 (3.8) | 2 (1.9) | |
Education, N (%) | 0.571 | ||
≤9 years | 93 (71.0) | 70 (76.9) | |
>9 years | 38 (29.0) | 34 (23.1) | |
Occupation, N (%) | 0.757 | ||
Employed | 102 (77.9) | 80 (80.8) | |
Unemployed | 29 (22.1) | 24 (19.2) | |
Alcohol use, yes, N (%) | 24 (18.3) | 19 (18.3) | 1.000 |
Smoking use, yes, N (%) | 10 (7.6) | 10 (9.6) | 0.642 |
Disease duration (years), Mean ± SD | 8.7 ± 9.1 | ||
Family history, yes, N (%) | 10 (7.6) | ||
Medications use, N (%) | |||
NSAIDs | 692 (52.7) | ||
Synthetic DMARDs | 129 (98.5) | ||
Biologic DMARDs | 11 (8.4) | ||
Glucocorticoid | 62 (47.3) | ||
ESR (mm/h), Mean ± SD | 28.47 ± 27. 64 | ||
CRP (mg/L), Mean ± SD | 16.61 ± 24.51 | ||
RF positive, N (%) | 102 (77.9) | ||
anti-CCP positive, N (%) | 91 (69.5) | ||
DAS28, Mean ± SD | 3.96 ± 1.44 | ||
HAQ-DI, Mean ± SD | 0.50 ± 0.61 | ||
Total pain (VAS), Mean ± SD | 4.32 ± 2.76 | ||
Nocturnal pain (VAS), Mean ± SD | 3.95 ± 3.22 | ||
HADS-A, Mean ± SD | 9.12 ± 2.79 | ||
HADS-D, Mean ± SD | 8.74 ± 2.46 |
Self-reported sleep quality
PSQI components score | Cases (n = 131) | Controls (n = 104) |
p
|
---|---|---|---|
Subjective sleep quality | 1.23 ± 0.74 | 0.63 ± 0.73 | <0.001 |
Sleep latency | 1.70 ± 1.04 | 0.70 ± 0.74 | <0.001 |
Sleep duration | 0.80 ± 1.05 | 0.70 ± 1.00 | 0.451 |
Habitual sleep efficiency | 1.16 ± 1.19 | 0.15 ± 0.41 | <0.001 |
Sleep disorders | 1.65 ± 0.69 | 0.90 ± 0.72 | <0.001 |
Use of sleep medications | 0.52 ± 1.04 | 0.06 ± 0.27 | <0.001 |
Daytime dysfunction | 0.88 ± 0.74 | 0.73 ± 0.80 | 0.148 |
Total | 7.93 ± 3.98 | 3.88 ± 1.89 | <0.001 |
Differences between good and poor sleepers in RA patients
Variables | PSQI < 5 (n = 28) | PSQI ≥ 5 (n = 103) |
p
|
---|---|---|---|
Female | 22 (78.6) | 90 (87.4) | 0.240 |
BMI (kg/m2) | 22.88 ± 3.40 | 22.39 ± 3.01 | 0.347 |
Age (years) | 54.79 ± 12.08 | 54.38 ± 11.45 | 0.872 |
Disease duration (years) | 8.21 ± 8.99 | 8.83 ± 9.15 | 0.749 |
Monthly income (yuan) | 0.141 | ||
<1000 | 12 (426.9) | 55 (53.4) | |
1000-3000 | 9 (32.1) | 38 (36.9) | |
3000-5000 | 6 (21.4) | 7 (6.8) | |
>5000 | 1 (3.6) | 3 (2.9) | |
Marital status | 0.273 | ||
Single | 1 (3.6) | 5 (4.9) | |
Married | 25 (89.3) | 94 (91.3) | |
Divorced | 1 (3.6) | 0 (0) | |
Widowed | 1 (3.6) | 4 (3.9) | |
Education | 0.240 | ||
≤9 years | 17 (60.7) | 76 (73.8) | |
>9 years | 11 (39.3) | 27 (26.2) | |
Occupation | 0.798 | ||
Employed | 21 (75.0) | 81 (78.6) | |
Unemployed | 7 (25.0) | 22 (21.4) | |
Smoking use, yes | 4 (14.3) | 6 (5.8) | 0.220 |
Alcohol use, yes | 4 (14.3) | 20 (19.4) | 0.783 |
Family history | 2 (7.1) | 8 (7.8) | 1.000 |
Medications use | |||
NSAIDs | 17 (60.7) | 52 (50.5) | 0.396 |
Synthetic DMARDs | 26 (92.9) | 103 (100.0) | 0.044 |
Biologic DMARDs | 2 (7.1) | 9 (8.7) | 1.000 |
Glucocorticoid | 11 (39.3) | 512 (49.5) | 0.396 |
ESR (mm/h) | 19.14 ± 15.96 | 31.00 ± 29.39 | 0.006 |
CRP (mg/dl) | 12.36 ± 25.00 | 17.7668 ± 24.37 | 0.336 |
RF positive | 19 (67.9) | 84 (80.6) | 0.198 |
anti-CCP positive | 19 (67.9) | 72 (69.9) | 0.821 |
DAS28 | 3.15 ± 1.39 | 4.17 ± 1.38 | 0.001 |
HAQ-DI | 0.20 ± 0.38 | 0.52 ± 0.65 | 0.002 |
Total pain (VAS) | 2.96 ± 1.86 | 4.69 ± 2.85 | 0.001 |
Nocturnal pain (VAS) | 2.66 ± 2.54 | 4.30 ± 3.30 | 0.007 |
HADS-A | 8.00 ± 2.46 | 9.42 ± 2.81 | 0.016 |
HADS-D | 7.25 ± 1.76 | 9.03 ± 2.49 | 0.001 |
Determinants of self-reported sleep quality in RA patients
Predictors | β | SE |
p
| Exp(B) | 95%CI | |
---|---|---|---|---|---|---|
Lower | Upper | |||||
HADS-D | 0.340 | 0.122 | 0.007 | 1.406 | 1.106 | 1.786 |
DAS-28 | 0.520 | 0.193 | 0.004 | 1.681 | 1.152 | 2.453 |
Effects of self-reported sleep quality on HRQoL
Variables | PSQI < 5 (n = 28) | PSQI ≥ 5(n = 103) |
p
|
---|---|---|---|
PF | 69.82 ± 28.07 | 54.27 ± 28.43 | 0.015 |
RP | 41.07 ± 48.70 | 17.23 ± 32.09 | 0.020 |
BP | 60.79 ± 24.72 | 44.91 ± 25.54 | 0.004 |
GH | 54.86 ± 21.70 | 38.29 ± 19.72 | <0.001 |
VT | 63.39 ± 17.69 | 48.59 ± 18.03 | <0.001 |
SF | 75.89 ± 26.12 | 58.62 ± 26.55 | 0.003 |
RE | 54.76 ± 46.45 | 31.39 ± 41.96 | 0.012 |
MH | 71.29 ± 18.48 | 58.56 ± 17.56 | 0.002 |
SF-36 PCS | 56.63 ± 24.63 | 38.68 ± 19.95 | 0.001 |
SF-36 MCS | 66.33 ± 22.72 | 49.30 ± 20.27 | 0.001 |
SF-36 components | β |
p
|
---|---|---|
PFa
| 0.057 | 0.471 |
RPb
| -0.018 | 0.836 |
BPc
| -0.060 | 0.383 |
GHd
| -0.016 | 0.067 |
VTe
| -0.097 | 0.255 |
SFf
| -0.204 | 0.012 |
REg
| -0.151 | 0.091 |
MHh
| -0.068 | 0.397 |
PCSi
| -0.045 | 0.527 |
MCSg
| -0.158 | 0.037 |