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Changes in sleep and clinical outcomes in hip osteoarthritis: A longitudinal secondary analysis of a randomised
Hanzhi Zhang1, Fiona Dobson2, Kim Allison3
1School of Health Science, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Objective:
To investigate whether improvements in sleep quality and duration are associated with improvements pain and physical function in people with hip osteoarthritis (OA) following exercise.
Methods:
Data from 185 participants with hip OA, randomized to an exercise intervention were pooled and analysed. Independent variables were changes in sleep quality using the Pittsburgh Sleep Quality Index (PSQI; 0-21, higher scores indicating poorer sleep) and sleep duration (hours) at 3 and 9 months. Outcomes were changes in hip pain severity (11-point numerical rating scale; 0-10) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index; 0-68). Associations were examined using linear regression models, adjusted for baseline values and covariates, and according to baseline sleep quality (PSQI >5 = poor sleep; ≤5 = good sleep).
Results:
At 3 months, each 1-point improvement in sleep quality was associated with reduced pain (-0.21 units; 95% CI: -0.32 to -0.09) and improved physical function (-1.45 units; 95% CI: -2.01 to -0.89). Each 1-h increase in sleep duration was associated with reduced pain (-0.34 units; 95% CI: -0.69 to 0.02) and improved physical function (-3.23 units, 95% CI -4.97 to -1.49). Similar associations were observed at 9 months. There were no statistically significant interactions between baseline sleep quality status (p = 0.055 to 0.994) and pain/physical function.
Conclusion:
Improvements in sleep quality and duration are associated with small improvements in pain and physical function following exercise. These relationships were consistent over time but of uncertain clinical relevance.
