Dose-response Relationship between Sleep and Rheumatoid Arthritis

Area of Science:

• Rheumatology
• Sleep Medicine
• Epidemiology

Background:

• Rheumatoid arthritis (RA) is a chronic autoimmune disease with significant public health implications.
• Understanding risk factors for RA, particularly modifiable ones like sleep, is crucial for prevention strategies.
• Low-income populations in rural areas may face unique challenges impacting health outcomes, including sleep and RA prevalence.

Purpose of the Study:

• To investigate the association between sleep quality, sleep duration, and the prevalence of rheumatoid arthritis (RA).
• To examine these associations in a low-income adult population residing in rural China.

Main Methods:

• A cross-sectional study involving 16,648 individuals in rural China using face-to-face investigations and questionnaires in 2017.
• Sleep quality and duration were assessed using the Pittsburgh Sleep Quality Index.
• Rheumatoid arthritis diagnosis was self-reported by participants based on physician diagnosis; statistical analyses included logistic regression and restricted cubic spline models.

Main Results:

• Short sleep duration (<7 hours) was associated with increased odds of RA (OR 1.49 for 6-7 hours, OR 1.70 for <6 hours).
• Poor sleep quality showed a significant association with RA prevalence (OR 1.68).
• Combinations of poor sleep quality with any sleep duration, and good sleep quality with short sleep duration, were linked to higher RA risk, indicating a non-linear relationship.

Conclusions:

• Poor sleep quality and insufficient sleep duration (<7 hours) are identified as potential trigger or risk factors for rheumatoid arthritis.
• These findings highlight the importance of addressing sleep health in public health initiatives targeting RA prevention, especially in vulnerable populations.