Content area
Abstract
Background
Over 50% of those with a diagnosis of Rheumatoid Arthritis (RA) experience poor sleep quality.Scott 2010 This may result in altered health-related quality of life in addition to decreased daytime function.
Objectives
The aim of this systematic review is to identify and compile an account of the correlates of poor sleep in those with RA.
Methods
Two reviewers carried out literature searches of nine electronic databases. Literature was chosen based on the application of eligibility criteria, implementation of quality assessment and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Moher et al 2009
Results
Fifteen full-text studies were included in the review - fourteen of cross-sectional design, and one randomised controlled trial (RCT). This included 3283 participants with a diagnosis of RA in accordance with the American College of Rheumatology criteria. The outcome measures included in the literature were largely heterogeneous in nature and therefore a meta-analysis was deemed to be unsuitable.
Conclusions
There is evidence within the literature to suggest that interactions between pain, fatigue, depression and functional ability play a role in sleep quality in those with RA. However, longitudinal data is required in order to determine the directionality of these relationships. The most prominent correlate of poor sleep is pain, with twelve studies identifying a positive association between the two variables. Conflicting evidence exsistswith regard to the association between sleep quality and disease activity, RA medications and patient demographics.
References
[1] Moher, D., Liberati, A., Tetzlaff, J. and Altman, D.G. (2009) 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement', PLoS Medicine, 6(7), 1-6, available: http://dx.doi.org/10.1371/journal.pmed.1000097.
[2] Scott, D.L., Wolfe, F. and Huizinga, T.W. (2010) 'Rheumatoid arthritis', Lancet, 376(9746), 1094-108, available: http://dx.doi.org/10.1016/s0140-6736(10)60826-4
Disclosure of Interest
None declared