EVALUATING THE IMPACT OF SLEEP DISTURBANCES AND DEPRESSION ON AXIAL SPONDYLOARTHRITIS A CROSS-SECTIONAL STUDY.
Main Article Content
Keywords
axial spondyloarthritis, sleep disturbances, depression, quality of life
Abstract
Background: Axial spondyloarthritis (axSpA) is a systemic inflammatory form of arthritis that presents itself by affecting the axial skeleton of the body especially the spine and sacroiliac joints presenting often with complaints of poor sleep and depression. It is crucial to develop such serious patient’s perception of the comorbidities that disrupt their quality of life and affect the disease course and treatment outcomes.
Objectives: The aims of this study were to determine the prevalence and effects of sleep disturbances and depression in axSpA over six months.
Study Design: A cross-sectional study.
Place and duration of study: from 10-October 2023 to 10-March 2024 and working as a senior resident in the department of Rheumatology in PIMS Hospital Islamabad.
Methods
A cross sectional study was conducted which comprised of 100 axSpA patients attending PIMS Hospital Islamabad. For evaluating the activity of the certain diseases the BASDAI was used; for the assessment of sleep quality – PSQI; for the evaluation of depression – HADS. To capture QoL, the ASQoL instrument was used with results reported as mean±SD. Data were also not analyzed for intercoefficients of disease activity, sleep interferences, and state of depressions.
Results: Out of the 100 participants, 74 Participants claimed to have severe sleep disturbances PSQI greater than 5, while 52 participated had distress symptoms indicating depression HADS D equal to or greater than 8. A positive correlation between BASDAI score, which showed a higher disease activity, and sleep disorders, r = 0. 65, p < 0. 001 as well as depression, r = 0. 59, p < 0. 001, was established. Patients with sleep disturbances and depression had significantly higher ASQoL scores, with those experiencing both comorbidities reporting the poorest quality of life (mean ASQoL score: The putative chimeric status of the CC also implicates it in potential contribution to the pathogenesis of human AA by this mechanism (12. 3). These results demonstrate significant paths in the psychological quality of life of axSpA patients by considering sleep and Mental Health.
Conclusion: The current and previous work showed high rates of sleep disturbances and depression in axSpA patients that highly negatively influence patients QoL. These findings underscore the importance of both screening and integrated care models to aid in management of the disease and therefore, bring to light the need to use multi-modal treatments for axSpA.
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17. Abad VC, Sarinas PSA, Guilleminault C. Sleep and rheumatologic disorders. Sleep Med Rev. 2008 Feb;12(3):211-28.
18. Palagini L, Tani C, Mauri M, et al. Sleep disorders and systemic lupus erythematosus. Lupus. 2014 Feb;23(2):115-23.
19. Matcham F, Rayner L, Steer S, et al. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2013 Dec;52(12):2136- 48.
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24. Brophy S, Cooksey R, Davies H, et al. The effect of anti-TNF-alpha therapy on sleep problems in patients with rheumatoid arthritis: results from the BSR biologics register. Rheumatology (Oxford). 2013 Feb;52(2):229-34.
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Sadia Mansoor
Resident Rheumatology PIMS, Islamabad
Shazia Zammurrad
Assistant Professor PIMS, Islamabad
Uzma Rasheed
HOD Rheumatology Department, PIMS Islamabad