Rheumatoid arthritis combined with insomnia: A multicenter cross-sectional survey

doi:10.3969/j.issn.1004-583X.2024.10.003

Abstract

Abstract:

Objective Circadian rhythm disorders links with autoimmune diseases. This study aims to explore the influencing factors for circadian rhythm disorders in patients with rheumatoid arthritis (RA) combined with insomni.Methods This was a multicenter cross-sectional clinical survey. Deputy chief physicians or above experienced in rheumatology were uniformly trained to collect relevant information through questionnaire surveys. The surveying questionnaire was designed from two dimensions of the insomnia severity index (ISI) and clinical information of RA patients. In 13 research centers in Hebei Province, RA outpatients or inpatients were screened according to inclusion and exclusion criteria. Relevant factors for insomnia in RA patients were compared and analyzed. Results A total of 181 RA patients were included in the analysis, including 60 (33.1%) with insomnia, and 121 without it. The male-to-female ratio was 1∶5. The average age of RA patients with insomnia was significantly older than those without insomnia (P<0.01). RA patients with comorbidities like hypertension, respiratory diseases, thyroid diseases, osteoporosis, or osteoarthritis had a significantly higher incidence of insomnia than those without comorbidities (P<0.05). RA patients taking traditional Chinese herbal medicine/ extracts of traditional Chinese medicine (TCM) had a significantly higher incidence of insomnia than those without TCM treatment (P=0.019). There was a significant difference in the incidence of insomnia among RA patients with varied disease activity scores and X-ray grading of hands (P<0.05). There were no significant differences in biochemical and immunological indicators between RA patients with or without insomnia (P>0.05). Conclusion A high proportion of RA patients suffer from insomnia, and the circadian rhythm disorder is associated with age, comorbidities, moderate-to-high disease activity, and radiographic grading.

Key words: arthritis, rheumatoid, sleep initiation and maintenance disorders, circadian rhythm disorder, cross-sectional survey

CLC Number:

R593.22

Dong Hong, Li Zhenbin, Ma Xu, Luo Yaping, Jiao Aijun, Zhang Xufei, Sun Caixia. Rheumatoid arthritis combined with insomnia: A multicenter cross-sectional survey[J]. Clinical Focus, 2024, 39(10): 882-888.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.10.003

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I10/882

Figures/Tables 7

References 26

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分级	DAS28 (CRP/ESR)	SDAI	CDAI
Ⅰ(缓解状态)	<2.6	≤3.3	≤2.8
Ⅱ(轻微)	≥2.6且≤3.2	>3.3且≤11	>2.8且≤10
Ⅲ(中度)	> 3.2且≤ 5.1	>11且≤22	>10且≤22
Ⅳ(重度)	> 5.1	> 22	>22

分级	DAS28 (CRP/ESR)	SDAI	CDAI
Ⅰ(缓解状态)	<2.6	≤3.3	≤2.8
Ⅱ(轻微)	≥2.6且≤3.2	>3.3且≤11	>2.8且≤10
Ⅲ(中度)	> 3.2且≤ 5.1	>11且≤22	>10且≤22
Ⅳ(重度)	> 5.1	> 22	>22

组别	例数	性别[例(%)]			年龄 (年)		身高 (cm)	体重 (kg)	BMI (kg/m²)	病程 (月)
组别	例数	男	女		年龄 (年)		身高 (cm)	体重 (kg)	BMI (kg/m²)	病程 (月)
失眠组	61	10(16.4)	51(83.6)	59.74±10.08		160.00(158.00, 166.50)		60.57±8.65	23.08±3.21	100(35.5, 210.5)
非失眠组	120	17(14.2)	103(85.8)	54.53±12.24		160.00(158.00, 165.00)		60.79±10.04	23.20±3.52	49(22.5, 143.25)
t/Z/χ²值		0.158		8.191		-0.261		0.020	0.052	-1.701
P值		0.691		0.005		0.789		0.887	0.820	0.088

组别	例数	性别[例(%)]			年龄 (年)		身高 (cm)	体重 (kg)	BMI (kg/m²)	病程 (月)
组别	例数	男	女		年龄 (年)		身高 (cm)	体重 (kg)	BMI (kg/m²)	病程 (月)
失眠组	61	10(16.4)	51(83.6)	59.74±10.08		160.00(158.00, 166.50)		60.57±8.65	23.08±3.21	100(35.5, 210.5)
非失眠组	120	17(14.2)	103(85.8)	54.53±12.24		160.00(158.00, 165.00)		60.79±10.04	23.20±3.52	49(22.5, 143.25)
t/Z/χ²值		0.158		8.191		-0.261		0.020	0.052	-1.701
P值		0.691		0.005		0.789		0.887	0.820	0.088

分类	例数		共病						高血压						糖尿病						高脂血症						脂肪肝
分类	例数		有			无			有			无			有			无			有			无			有		无
失眠	61		53(36.8)			8(21.6)			30(43.5)			31(27.7)			5(25.0)			56(34.8)			11(35.5)			50(33.2)			0(0.0)		61(34.7)
非失眠	120		91(63.2)			29(78.4)			39(56.5)			81(72.3)			15(75.0)			105(65.2)			20(64.5)			100(66.8)			5(100.0)		115(65.3)
χ²值			3.043						4.771						0.758						0.051						2.609
P值			0.056						0.023						0.270						0.485						0.123
分类		肝炎						肝功能异常						肾功能不全						冠心病						慢性胃炎
分类		有			无			有			无			有			无			有			无			有		无
失眠		2(66.7)			59(33.1)			6(42.9)			55(32.9)			5(62.5)			56(32.4)			8(50.0)			53(32.1)			9(45.0)		52(32.2)
非失眠		1(33.3)			119(66.9)			8(57.1)			112(67.1)			3(37.5)			117(67.6)			8(50.0)			112(67.9)			11(55.0)		109(67.7)
χ²值		1.480						0.570						3.107						2.090						1.290
P值		0.263						0.316						0.094						0.117						0.191
分类		呼吸系统病						贫血						白细胞减少						甲状腺疾病						肿瘤
分类		有			无			有			无			有			无			有			无			有		无
失眠		15(57.7)			46(29.7)			15(38.5)			46(32.5)			1(10.0)			60(35.1)			4(80.0)			57(32.4)			3(75.0)		58(32.8)
非失眠		11(42.3)			109(70.3)			24(61.5)			96(67.)			9(90.0)			111(64.9)			1(20.0)			119(67.6)			1(25.0)		119(67.2)
χ²值		7.820						0.500						2.664						4.931						3.122
P值		0.007						0.301						0.906						0.042						0.108
分类	骨质疏松症						骨关节炎						高尿酸血症						痛风						其他风湿免疫疾病				其他疾病
分类	有			无			有			无			有			无			有			无			有		无		其他疾病
失眠	22(50.0)			39(28.5)			27(65.9)			34(4.3)			3(37.5)			58(33.5)			1(33.3)			60(33.7)			3(75.0)		58(32.8)		14(42.4)
非失眠	22(50.0)			98(71.5)			14(34.1)			106(75.7)			5(62.5)			115(66.5)			2(66.7)			118(66.3)			1(25.0)		119(67.2)		19(57.6)
χ²值	6.912						24.520						0.052						0.009						0.134
P值	0.007						0.000						0.543						0.744						0.110