Sleep Disorders among Individuals with Rheumatoid Arthritis

Background: Self-reported sleep problems are common in RA with potential negative health implications, yet relatively little research has focused on sleep in RA. We examined the prevalence of obstructive sleep apnea (OSA) risk, restless legs syndrome (RLS) symptoms, and short sleep (SS) in a large RA cohort (n=4200), and factors associated with each. Methods: Data are from FORWARD, The National Databank for Rheumatic Diseases. Validated screening measures assessed OSA risk and RLS symptoms. SS was based on self-reported average sleep time (<6 hours). The Medical Outcomes Study Sleep Problems Index I measured self-reported sleep quality. Multivariable logistic regression models identified independent predictors of sleep disorders and sleep quality and the independent association of OSA risk, RLS symptoms, and SS with self-reported poor sleep quality. Results: Twenty-one percent (n=899) had OSA diagnosis or risk, 30% (n=1272) had RLS symptoms or diagnosis, and 43% (n=1737) reported SS, and. RA disease activity was associated with each sleep disorder. Abatacept use was associated with lower odds of RLS and SS. Use of conventional DMARDS or abatacept were less frequent in the SS group. No medications were associated with OSA in multivariable analyses. Both RLS and SS were associated with worse perceived sleep quality. Discussion: Almost two thirds met criteria for at least one sleep disorder. RA disease activity and pain were significantly associated with each sleep condition. Additional research is needed to identify the causal pathway between sleep disorders and RA disease activity and pain and the long-term consequences of sleep disorders in RA. This article is protected by copyright. All rights reserved.