Sleep fragmentation in rheumatoid arthritis

Sleep fragmentation in rheumatoid arthritis Fatigue is commonly reported by patients with rheumatoid arthritis (RA), and it is frequently used to evaluate disease activity and response to therapy. We theorized that the feeling of fatigue in patients with RA may be a manifestation of disturbance of sleep. Sixteen patients with chronic, active RA, who were selected for early onset of fatigue (<6 hours after morning awakening), were extensively evaluated by formal all‐night polysomnographic recording and multiple sleep latency testing (MSLT). Although no sleep deprivation was found, all patients had some type of marked disturbances of sleep, including unanticipated sleep apnea (2 patients), frequent movement of extremities (all 16 patients), and frequent arousal (all 16 patients). The alpha‐delta sleep pattern was present in 13 patients, and 7 were found by MSLT to be hypersomnolent. None of the patients accurately recognized the degree of their sleep disruption. Our findings from the MSLT indicate that fatigue in patients with RA may be a manifestation of sleep fragmentation, rather than a nonspecific constitutional symptom. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Arthritis & Rheumatology Wiley

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Publisher
Wiley
Copyright
Copyright © 1989 Wiley Subscription Services, Inc., A Wiley Company
ISSN
2326-5191
eISSN
2326-5205
DOI
10.1002/anr.1780320806
Publisher site
See Article on Publisher Site

Abstract

Fatigue is commonly reported by patients with rheumatoid arthritis (RA), and it is frequently used to evaluate disease activity and response to therapy. We theorized that the feeling of fatigue in patients with RA may be a manifestation of disturbance of sleep. Sixteen patients with chronic, active RA, who were selected for early onset of fatigue (<6 hours after morning awakening), were extensively evaluated by formal all‐night polysomnographic recording and multiple sleep latency testing (MSLT). Although no sleep deprivation was found, all patients had some type of marked disturbances of sleep, including unanticipated sleep apnea (2 patients), frequent movement of extremities (all 16 patients), and frequent arousal (all 16 patients). The alpha‐delta sleep pattern was present in 13 patients, and 7 were found by MSLT to be hypersomnolent. None of the patients accurately recognized the degree of their sleep disruption. Our findings from the MSLT indicate that fatigue in patients with RA may be a manifestation of sleep fragmentation, rather than a nonspecific constitutional symptom.

Journal

Arthritis & RheumatologyWiley

Published: Aug 1, 1989

References

  • Clinical appraisal of the activity index as a measure of rheumatoid activity
    Lansbury, J
  • Statistical approach to indices of disease activity in rheumatoid arthritis
    McGuire, RJ; Wright, V
  • Cricoarytenoid arthritis: a cause of laryngeal obstruction
    Leicht, MJ; Harrington, TM; Davis, DE
  • Rheumatic pain modulation syndrome: the interrelationships between sleep, central nervous system serotonin, and pain
    Moldofsky, H
  • A Manual of Standardized Terminology: Techniques and Scoring System for Sleep Stages of Human Subjects
  • Measurements of all‐night sleep in normal elderly persons: effects of aging
    Kales, A; Wilson, T; Kales, JD; Jacobson, A; Paulson, MJ; Kollar, E; Walter, RD
  • Somatosensory and brain‐stem auditory evoked responses in sleep‐related periodic leg movements
    Mosko, SS; Nudleman, KL

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