Sleep Fragmentation and Biomarkers in Juvenile Idiopathic Arthritis
Teresa M Ward1, Weichao Yuwen2, Joachim Voss3
1Department of Family and Child Nursing, School of Nursing, University of Washington, Seattle, WA, USA teward@uw.edu.
Insights
Children with juvenile idiopathic arthritis (JIA) experience fragmented sleep, impacting biomarkers like MRP8/14. Sleep fragmentation is linked to increased MRP8/14 protein concentration in JIA patients.
Area of Science:
- Pediatric Rheumatology
- Sleep Medicine
- Biomarker Research
Background:
- Juvenile idiopathic arthritis (JIA) is a chronic condition affecting children, with potential impacts on sleep quality.
- Sleep disturbances are common but understudied in pediatric rheumatic diseases.
- Biomarkers such as S100A12 and myeloid-related protein (MRP8/14) are implicated in inflammatory processes.
Purpose of the Study:
- To compare sleep parameters and symptoms in children with polyarticular and extended oligoarticular JIA.
- To investigate the association between sleep fragmentation and specific inflammatory biomarkers (S100A12, MRP8/14).
Main Methods:
- Actigraphy was used to measure sleep duration, efficiency, and fragmentation in 40 children with JIA.
- Participants completed validated questionnaires for fatigue, pain, and sleep habits (CSHQ).
- Serum protein concentrations for S100A12 and MRP8/14 were measured.
Main Results:
- A high prevalence of sleep disturbances (68%) was reported based on the CSHQ.
- No significant group differences were found in sleep duration, efficiency, or fragmentation between JIA categories.
- Sleep fragmentation (movement and fragmentation index) was a significant predictor of MRP8/14 protein concentration, explaining 21% of the variance.
Conclusions:
- Fragmented sleep is prevalent in children with JIA, irrespective of disease subtype.
- Sleep fragmentation is associated with elevated MRP8/14 levels, suggesting a link between sleep disruption and inflammation.
- Further research is warranted to explore the interplay of sleep, medication, and biomarkers in JIA management.
Objectives:
(1) To compare sleep (nighttime sleep duration and sleep efficiency) and sleep fragmentation (movement and fragmentation index), as measured by actigraphy, and symptoms (pain and fatigue) in 8- to 14-year-old children with polyarticular and extended oligoarticular juvenile idiopathic arthritis (JIA) and (2) to examine the associations between sleep fragmentation (movement and fragmentation index) and the calcium-binding protein biomarkers S100A12 and myeloid-related protein (MRP8/14).
Method:
Participants included 40 children with extended oligoarticular (n = 15) or polyarticular (n = 25) JIA and their parents. Serum protein samples were obtained during routine rheumatology clinic visits. Children completed the PedsQL Multidimensional Fatigue Scale and daily pain and sleep diaries and wore actigraphy monitors for 9 consecutive days. Parents completed the Children's Sleep Habits Questionnaire (CSHQ).
Results:
Of the 40 children, 68% scored above the CSHQ clinical cutoff score for sleep disturbances. Mean nighttime sleep duration was 7.5 hr, and mean sleep efficiency was 85.3%. Group differences were not found for nighttime sleep duration, sleep efficiency, movement and fragmentation index, or S100A12 and MRP8/14 protein concentrations. In a stepwise regression, medications, joint count, and movement and fragmentation index explained 21% of the variance in MRP8/14 concentration.
Conclusion:
Decreased nighttime sleep duration, poor sleep efficiency, and fragmented sleep were observed in our sample, regardless of JIA category. Sleep fragmentation was a significant predictor of MRP8/14 protein concentration. Additional research is needed to understand the interrelations among sleep fragmentation, effects of medication, and S100A12 and MRP8/14 protein biomarkers in JIA.
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