Time to wake up to the potential benefits of targeting sleep in osteoarthritis management

Sleep disturbance is highly prevalent in people with osteoarthritis (OA) yet it is rarely considered in routine care. Emerging evidence suggests that sleep disturbance contributes to heightened musculoskeletal pain and poorer physical and emotional outcomes in those with OA. This narrative review synthesises current knowledge on the epidemiology and impact of sleep disturbances in OA, including their associations with and impact on fatigue, depressive symptoms, pain catastrophising, and negative mood. It examines the effects of core OA treatments such as exercise, diet and weight loss on sleep, as well as the potential for sleep-focused therapies such as cognitive behavioural therapy for insomnia to improve pain in OA populations. The review also considers how addressing sleep may offer a novel pathway to enhance clinical outcomes and identifies health professionals who may be well placed to deliver sleep care to individuals living with OA. Incorporating sleep into OA management presents an innovative, high-impact, and low-risk opportunity to improve patient outcomes.