Prevalence and factors associated with disturbed sleep in outpatients with ankylosing spondylitis
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Sleep disturbance is prevalent among patients with ankylosing spondylitis (AS) and is considered a multifactorial issue. The study was designed to investigate sleep disturbance and its associated factors in AS outpatients in Southwest China. Patients were recruited by convenience sampling in this cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI), the Bath AS Disease Activity Index (BASDAI), the Bath AS Functional Index (BASFI), the Bath AS Patient Global Score (BAS-G), and the Hospital Anxiety and Depression Scale (HADS) were used to assess sleep quality, disease activity, function status, global well-being, depression, and anxiety. Spearman’s correlation, t test, ANOVA, and multiple linear regression analysis were used to explore the associated factors of sleep disturbance. Of the 281 outpatients included in the study, 190 (67.6%) patients had sleep disturbance. The married patients, the patients with extra-spinal manifestation, depression and anxiety, longer duration of diagnostic delay, higher disease activity, worse functional status and global well-being, high level of pain, and fatigue, had poorer sleep quality (P < 0.05). Multiple linear regression analysis revealed age (β = 0.087, P = 0.102), BAS-G (β = 0.181, P = 0.003), fatigue (β = 0.170, P = 0.002), anxiety (β = 0.151, P = 0.002) and nocturnal back pain (β = 0.192, P = 0.001), extra-spinal manifestation (β = 0.120, P = 0.012), and duration of diagnostic delay (β = 0.174, P = 0.001) were the contributors to PSQI. Sleep disturbance is common in AS patients in Southwest China. It may be useful to keep regular exercise, strengthen the management of pain, relieve anxiety, and prevent and treat extra-spinal manifestation for improving sleep quality.
KeywordsAnkylosing spondylitis China Sleep disturbance Sleep quality
We would like to offer a special acknowledgement to all patients who participated in the study and investigators for their valuable help in patient recruitment and data collection.
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 6.Ates A, Dortbas F, Karaaslan Y (2015) The relationship between disease activity, functional index, sleep quality, anxiety, depression, fatigue and quality of life in patients with ankylosing spondylitis. Ann Rheum Dis 74(Suppl2):497–498Google Scholar
- 8.Hakkou J, Rostom S, Mengat M, Aissaoui N, Bahiri R, Hajjaj-Hassouni N (2013) Sleep disturbance in Moroccan patients with ankylosing spondylitis: prevalence and relationships with disease-specific variables, psychological status and quality of life. Rheumatol Int 33(2):285–290CrossRefPubMedGoogle Scholar
- 13.Shen TC, Liang SJ, Lin CL, Tu CY, Hsia TC, Shih CM (2016) Ankylosing spondylitis and the subsequent risk of sleep disorders: a retrospective population-based cohort study in Taiwan. J Intern Med 27(2):79–88Google Scholar
- 21.Cherif I, Hamdi W, Kaffel D, Zouch I, Kchir M (2014) Correlation between sleep disturbance, fatigue and psychological features in patients with ankylosing spondylarthritis. Ann Rheum Dis 73(Suppl 2):1035Google Scholar
- 22.Aissaoui N, Rostom S, Hakkou J, Berrada Ghziouel K, Bahiri R, Abouqal R, Hajjaj-Hassouni N (2012) Fatigue in patients with ankylosing spondylitis: prevalence and relationships with disease-specific variables, psychological status, and sleep disturbance. Rheumatol Int 32(7):2117–2124CrossRefPubMedGoogle Scholar
- 25.Liu XC, Tang MQ, Hu L (1996) Reliability and validity of the Pittsburgh Sleep Quality Index. Chin J Psychiatry 2:103–107Google Scholar
- 30.Ye WF, Xu JM (1993) The application and evaluation of the hospital anxiety and depression scale in general hospital patients. Chin J Behav Med Brain Sci 3:17–19Google Scholar
- 34.Jiang Y, Yang M, Wu H, Song H, Zhan F, Liu S, Gao G, Liu Z, Hu Z, He P, Zhang S, Hu Z, Lin Z, Zhang Y, Li Y, Shen L, Huang A, Liao Z, Cao S, Wei Y, Li L, Li Q, Lv Q, Qi J, Huang J, Li T, Jin O, Pan Y, Gu J (2015) The relationship between disease activity measured by the BASDAI and psychological status, stressful life events, and sleep quality in ankylosing spondylitis. Clin Rheumatol 34(3):503–510CrossRefPubMedGoogle Scholar
- 35.Zhang SL, Li Y, Zhu J, Huang ZF, Zhang JL, Huang F (2013) Relationship between sleep quality and nocturnal pain in ankylosing spondylitis. Natl Med J China 93(13):970–972Google Scholar
- 37.Billington J, Farrington G, Lampropoulou S, Lingwood J, Jones A, Ledson J, et al (2016) A comparative study of cognitive behavioural therapy and shared reading for chronic pain. Med Humanit: medhum-2016-011047Google Scholar