Spotlight on Research 2011

February 2011

Large-Scale Study Identifies Factors for Sleep Disturbance in Arthritis

A restful night's sleep may seem like a dream for 10.2 million adults with arthritis, according to a new study conducted by researchers in the Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Because pain affects sleep, and insufficient sleep can have many negative effects on health and quality of life, researchers wanted to better understand the prevalence of sleep disturbance in people with arthritis, a collection of conditions characterized by joint pain, swelling and stiffness. They turned to the 2007 National Health Interview Survey – a national population-based survey of the health of civilian non-institutionalized U.S. residents – for answers. Using data on American adults participating in the survey, the researchers computed the prevalence of three types of sleep disturbance – insomnia, excessive daytime sleepiness and sleep duration of less than six hours a night – among people with arthritis.

After controlling for demographic characteristics such as age, sex, race, ethnicity, education, employment and marital status and comorbid condition, including hypertension, cardiac disease, diabetes, cancer and depression and anxiety, they found that all three types of sleep disturbance were increased among people with arthritis. The study further found that depression and anxiety were the two strongest factors that put people with arthritis at increased risk for sleep disturbance, says Michael M. Ward, M.D., senior investigator in the NIAMS Intramural Research Program.

While other studies have shown a connection between sleep and arthritis, he says, many have been small, used different methods to assess sleep disturbance or focused on a particular form of arthritis. The new study, one of the largest to date, includes people with any form of doctor-diagnosed arthritis.

Because sleep disturbance has major influences on quality of life, vocation performance, morbidity and healthcare use, treating the problem to promote sleep is important, he says. The new study suggests two places doctors could potentially intervene. One would be to assess and treat depression and anxiety, which may, in turn, improve sleep and consequently improve functioning in general, he says. The other would be to treat joint pain more effectively.

Fortunately, effective therapies already exist for pain, anxiety and depression. Thus, identifying people who could benefit from those therapies and using them appropriately, could potentially enable people with arthritis to get the restful sleep they need.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For more information about the NIAMS, call the information clearinghouse at (301) 495-4484 or (877) 22-NIAMS (free call) or visit the NIAMS website at http://www.niams.nih.gov.

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Louie GH, Tektonidou MG, Caban-Martinez AJ, Ward MM. Sleep disturbances in adults with arthritis: Prevalence, mediators, and subgroups at greatest risk. Data from the 2007 National Health Interview Survey. Arthritis Care Res(Hoboken). 2011 Feb; 63(2):247-60.