医学
银屑病性关节炎
多导睡眠图
匹兹堡睡眠质量指数
物理疗法
活动记录
内科学
睡眠障碍
阻塞性睡眠呼吸暂停
血沉
睡眠呼吸暂停
失眠症
疾病
睡眠质量
精神科
呼吸暂停
昼夜节律
作者
Carly Grant,Michael J. Woodbury,Marie Skougaard,Jens Kjærgaard Boldsen,Alexis Ogdie,Elizabeth B. Klerman,Joseph F. Merola,Lourdes M. Pérez-Chada
标识
DOI:10.3899/jrheum.2022-1169
摘要
Objective The aim of this systematic review and metaanalysis is to summarize evidence regarding the relationship between psoriatic arthritis (PsA) and sleep problems. Methods We identified 36 eligible studies—26 cross-sectional, 7 cohort, and 3 interventional studies—in PubMed and Embase. Results The prevalence of self-reported sleep problems in patients with PsA ranged from 30% to 85%. A metaanalysis of 6 studies that used the Pittsburgh Sleep Quality Index revealed a prevalence of poor sleep quality for patients with PsA of 72.9% (95% CI 63-81.8; I 2 = 78%), which was statistically higher than in healthy controls (26.9%, 95% CI 11.7-45.4; I 2 = 81%) but not significantly different than in patients with psoriasis (59.8%, 95% CI 46.9-72.1; I 2 = 51%). Sleep disturbance was ranked in the top 4 health-related quality of life domains affected by PsA. One study suggested a bidirectional relationship between PsA and obstructive sleep apnea. Predictors of sleep problems included anxiety, pain, erythrocyte sedimentation rate, depression, fatigue, physical function, and tender or swollen joint count. Tumor necrosis factor inhibitors, guselkumab, and filgotinib (a Janus kinase inhibitor) were associated with improved sleep outcomes. Conclusion Poor sleep quality is prevalent in patients with PsA. Objective sleep measures (ie, actigraphy and polysomnography) have not been used in PsA studies, and evidence on the validity of patient-reported sleep measures in PsA is lacking. Future studies should validate self-reported sleep measures in PsA, explore how sleep quality relates to PsA disease activity and symptoms using both objective and subjective sleep measures, assess the efficacy of strategies to manage sleep problems, and assess the effects of such management on symptoms and disease signs in patients with PsA.
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