Determinants of sleep impairment in psoriatic arthritis: an observational study with 396 patients from 14 countries – DocWire News

OBJECTIVE:

Sleep quality is diminished in patients with psoriaticarthritis(PsA) and close to 40% of PsA patients consider sleep difficulties a priority domain. This work analyzes determinants of impaired sleep in patients with PsA.

This was a cross-sectional analysis of an observational study (ReFlap, NCTNCT03119805), which included adult patients with definite PsA with 2 years disease duration from 14 countries. Sleep was assessed using the patient self-reported evaluation of sleep on a 0-10 numerical scale, included in the PsoriaticArthritisImpact of Disease questionnaire (PSAID-12). A score 4 was considered as sleep impairment. Demographic and clinical variables associated to sleep impairment were assessed through univariate analysis and Poisson regression modeling leading to prevalence ratio (PR) [95% confidence interval].

A total of 396 patients were analyzed: mean age 51.912.6 years, 51% were females, 59.7% were receiving biologic therapy, 53.3% had 1-5% of body surface area affected by psoriasis; 23.7% were in remission and 36.9% in low disease activity according to the Disease Activity in PsoriaticArthritis(DAPSA) score. Median (25th-75th) patients self-evaluation of sleep difficulties was 2 (0-6), 157 (39.6%) had sleep impairment. In the Poisson regression model, self-reported levels of anxiety (PR: 1.05 [1.02-1.08], p=0.003) and pain (PR: 1.06 [1.04-1.09], p<0.001) were independently associated to sleep impairment.

In this multicentric study, sleep impairment was present in 40% of PsA patients; pain and anxiety were associated to sleep impairment whereas inflammation was not. Impact on sleep appears multifactorial in PsA.

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Determinants of sleep impairment in psoriatic arthritis: an observational study with 396 patients from 14 countries - DocWire News