Depressive symptoms are associated with impaired sleep, fatigue, and disease activity in women with rheumatoid arthritis

Advances in Rheumatology

Max Victor Carioca Freitas¹  Fernando Henrique Azevedo Lopes²  Veralice Meireles Sales de Bruin²  Pedro Felipe Carvalhedo de Bruin² 

[1] Dr. Cesar Cals General Hospital, Fortaleza, Ceara, Brazil;Laboratory of Sleep and Biological Rhythms, Department of Medicine, Federal University of Ceara, Rua Prof. Costa Mendes 1608 – 4° andar, CEP 60430-971, Fortaleza, Ceara, Brazil;

关键词: Rheumatoid arthritis;    Sleep;    Fatigue;    Sleepiness;    Depression;   

DOI  :  10.1186/s42358-021-00176-6

来源: Springer

【 摘 要 】

ObjectivesTo investigate the associations between sleep quality, fatigue, disease activity and depressive symptoms in women with rheumatoid arthritis (RA).MethodsFemale patients with previous diagnosis of RA from a Rheumatology Outpatient Clinic at a tertiary referral centre, in Fortaleza, Brazil, were consecutively recruited into the study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI); fatigue by the Fatigue Severity Scale (FSS); daytime sleepiness by the Epworth Sleepiness Scale (ESS); and depressive symptoms by the Beck Depression Inventory II (BDI-II). RA activity was measured by the disease activity score (DAS28).ResultsOne hundred ten women (mean age ± SD = 51.1 ± 13.0 y) were included in the study. On average, patients with depressive symptoms (BDI-II > 13), as compared to those without, showed poorer sleep quality (PSQI: 10.09 ± 4.1 vs 7.33 ± 3.55; p = 0.001 respectively), more fatigue (FSS: 4.69 ± 1.89 vs 3.34 ± 1.8; p = 0.001) and higher disease activity level (DAS28: 4.36 ± 1.53 vs 3.7 ± 1.39; p = 0,047). The logistic regression analysis showed that sleep quality is an independent predictor of depressive symptom severity.ConclusionDepressive symptoms, impaired sleep and fatigue are common in women with RA. Poor sleep is associated with greater frequency and severity of depressive symptoms in these patients, suggesting that screening for sleep and mood problems may be relevant both in clinical research and routine patient care. Future studies investigating the impact of measures to promote healthy sleep on depressive symptom control in this patient population are warranted.

【 授权许可】

CC BY