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More Than Pain and Stiffness: Persistent Fatigue and Sleep Disturbance in Polymyalgia Rheumatica.

Jessica L Leung1, Belinda De Ross2, Jenny Gianoudis2

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The Journal of Rheumatology
|April 1, 2025
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Summary

Patients with polymyalgia rheumatica (PMR) experience significant fatigue and sleep issues, persisting for nearly two years. Higher BMI, psychological distress, and disease activity are linked to this fatigue.

Keywords:
fatiguepolymyalgia rheumaticasleepsleep durationsleep quality

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Area of Science:

  • Rheumatology
  • Clinical Medicine
  • Patient-Reported Outcomes

Background:

  • Polymyalgia rheumatica (PMR) is an inflammatory condition affecting older adults.
  • Fatigue and sleep disturbances are common but understudied in PMR patients.
  • Understanding these symptoms is crucial for effective patient management.

Purpose of the Study:

  • To compare fatigue and sleep disturbance in newly diagnosed PMR patients versus controls.
  • To identify factors associated with fatigue and sleep issues in PMR.
  • To track changes in these symptoms over an 18-month period.

Main Methods:

  • Prospective recruitment of PMR patients and age/gender-matched controls.
  • Quantitative assessment of fatigue (multidimensional questionnaire, vitality scale) and sleep quality (Pittsburgh Sleep Quality Index).
  • Evaluation of PMR disease activity, psychological status, physical function, and body composition.

Main Results:

  • PMR patients reported significantly higher rates of severe fatigue (36-35%) compared to controls (3%).
  • Poor sleep quality was more prevalent in PMR patients (77-84%) than controls (56%).
  • Severe fatigue in PMR was associated with higher BMI, fat mass index, anxiety, depression, disease activity, and inflammatory markers.

Conclusions:

  • PMR patients experience substantial and persistent fatigue and sleep disturbances, even after nearly two years of treatment.
  • Adiposity, psychological comorbidities, and PMR disease activity are key factors associated with fatigue in PMR.
  • These findings highlight the need for integrated management strategies addressing both disease-specific and general health factors in PMR.