Related Experiment Videos
Sleep and its relationship to pain, dysfunction, and disease activity in juvenile rheumatoid arthritis
Bradley J Bloom1, Judith A Owens, Melissa McGuinn
1Department of Pediatrics, Hasbro Children's Hospital and Brown University School of Medicine, Providence, RI 02903, USA.
Insights
Children with juvenile rheumatoid arthritis (JRA) experience significant sleep abnormalities, including issues with waking, breathing, and daytime sleepiness. These sleep problems are multi-dimensional and common in pediatric JRA patients.
Area of Science:
- Pediatric Rheumatology
- Sleep Medicine
- Child Health
Background:
- Juvenile rheumatoid arthritis (JRA) is a chronic inflammatory condition affecting children.
- Sleep disturbances are increasingly recognized as a significant issue in chronic pediatric diseases.
- Understanding sleep abnormalities in JRA is crucial for comprehensive patient care.
Purpose of the Study:
- To identify sleep abnormalities in children diagnosed with juvenile rheumatoid arthritis (JRA).
- To investigate the relationship between these sleep abnormalities and key disease indicators: pain, functional impairment, and overall disease activity.
Main Methods:
- Sleep assessment in 25 active JRA patients using validated questionnaires (Sleep Self-Report, SSR; Children's Sleep Habits Questionnaire, CSHQ).
- Evaluation of disease activity via physician/parent global assessments, ESR, and joint counts.
- Functional assessment using the Juvenile Arthritis Functional Assessment Report (JAFAR) and pain assessment via visual analog scale.
Main Results:
- JRA patients exhibited significantly higher scores on the CSHQ, indicating widespread sleep issues (p < 0.0001).
- Specific CSHQ subscales showing abnormalities included night wakings, parasomnias, sleep anxiety, sleep-disordered breathing, and daytime sleepiness (p < 0.0001–0.05).
- The SSR total score correlated with pain (r = 0.56, p = 0.005), but CSHQ scores did not correlate with JRA disease activity or pain.
Conclusions:
- Sleep abnormalities are prevalent and multi-dimensional in children with juvenile rheumatoid arthritis.
- While specific sleep issues are common, their direct correlation with disease activity and pain requires further investigation.
- Addressing sleep disturbances should be an integral part of managing pediatric JRA.
Objective:
To determine what sleep abnormalities may exist in children with juvenile rheumatoid arthritis (JRA). and their relationship to pain, dysfunction. and disease activity.
Methods:
Twenty-five children with active JRA (11 pauciarticular, 9 polyarticular, 5 systemic) had their sleep assessed by parallel, validated patient and parent questionnaires (Sleep Self-Report, SSR, and Children's Sleep Habits Questionnaire, CSHQ). Disease activity was assessed by parent and physician global assessments (on a 5 point scale: 0 = no disease activity to 4 = very severe disease), erythrocyte sedimentation rate (ESR), and numbers of swollen and limited joints. Functional assessment was based on parental completion of the Juvenile Arthritis Functional Assessment Report (JAFAR). Pain was assessed by the average pain visual analog scale of the Varni Pediatric Pain Questionnaire. Results were compared to those from 45 healthy age and sex matched controls by Mann-Whitney U tests, and correlated with variables of JRA disease activity, function, and pain using Spearman correlations.
Results:
Patients with JRA had higher total score on the CSHQ (p < 0.0001), as well as subscales assessing night wakings, parasomnias. sleep anxiety, sleep-disordered breathing, and morning wakening/daytime sleepiness (p < 0.0001-0.05). There were no correlations between CSHQ scores and JRA disease activity or pain variables, but the total score on the SSR did correlate with pain (r = 0.56, p = 0.005).
Conclusion:
We conclude that sleep abnormalities are common in children with JRA, and are multi-dimensional.