Osteoarthritis and Sleep Disturbance
Recent reports have demonstrated the negative effects of sleep disturbances on a broad range of health outcomes including respiratory infections, cardiovascular events, and weight gain. In 2012 nearly 1/3 of adults in the United States reported insufficient sleep and this is compared with 1/5 of US adults three decades ago.
Among individuals with osteoarthritis (OA), sleep disturbance may be more prevalent than in the general population. Pain and mental health disorders often coexist leading to a deteriorating quality-of-life. Despite frequent complaints of sleep disturbance among adults with OA, not much is known about sleep patterns in this population or how they change over time.
Research on sleep has shown that patterns change over time and are likely to be heterogeneous. Indeed, literature evaluating sleep patterns is limited. Because longitudinal sleep studies have not been done in adults with osteoarthritis it is not clear that sleep trajectories will be the same in this population compared with other non-disease-specific populations.
In this article, the authors analyze sleep disturbance measured by the report of restless sleep among adults with or at high risk for osteoarthritis of the knee. The objectives were to identify trajectories of restless sleep over an eight year interval and to identify baseline health and behavioral factors associated with unfavorable trajectories. As there is no cure for OA, disease management is primarily focused on addressing symptoms, and developing a better understanding of sleep patterns that may further motivate multi modal approaches to achieve osteoarthritis treatment goals. Determining modifiable factors that predict positive outcomes could inform more effective interventions.
The Osteoarthritis Initiative is a longitudinal observational cohort study of the natural history of knee OA and associated risk factors. Four restless sleep trajectory groups were identified: good, (persistently low restless), worsening, improving, and poor. The poor group had an increased likelihood of baseline depressive symptoms.
In conclusion four trajectories of restless sleep over eight years were identified using data collected from over 4000 older adults age 45 to 79 who were at high risk for knee osteoarthritis. The presence of depressive symptoms, less physical activity, knee pain, poor mental health, cardiovascular disease and pulmonary disease were each associated with unfavorable trajectories.
Song, J: Sleep Disturbance Trajectories in Osteoarthritis. J Clin Rheumatol (In Press)