Less Pain, Better Sleep May Help Control Rheumatoid Arthritis, Study Finds

Relieving pain and improving sleep may be key factors in decreasing the severity of rheumatoid arthritis (RA), according to a recent study’s findings.

Some prior studies have identified associations between sleep problems increased levels of inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), but the complexity of RA has made investigation into this topic challenging. A recent descriptive-correlative study sought to better understand the relationship among pain, sleep, and inflammatory markers in order to develop strategies to reduce inflammatory markers and prevent increased disease activity.

In the study, which was published in the Journal of Caring Sciences, 210 patients with RA completed the Sleep Disorders Questionnaire, the Epworth Sleepiness Scores, and the Numeric Pain Rating Scale. Researchers obtained CRP and ESR data for the participating patients from recent blood tests. Correlations between variables were evaluated using a Spearman test.

The most common self-reported sleep disorders were napping during the day (83.8%) and trouble falling asleep (73.3%). Most of the participants (83.3%) also reported moderate to severe pain, and most (81%) had positive CRP.

The Spearman test demonstrated a significant relationship (P <.001) between pain and sleep difficulties, which included the following problems:

• Apnea (r = 0.55)
• Asphyxia (r = 0.50)
• Delay in sleep (r = 0.58)
• Twitching feet (r = 0.45)
• Numbness (0.51)

A Pearson correlation also showed significant relationships (P <.001) between the following inflammatory markers and pain:

• Rheumatic factor (r = 0.23)
• CRP, (r = 0.32)
• ESR, (r = 0.59)

Some prior studies have shown that sleep problems are common among patients with RA, while others have demonstrated correlations between inflammatory markers and increased pain. However, this study is among the first to point to both a significant relationship between inflammatory markers and sleep problems as well as to a positive and meaningful relationship between pain and inflammatory markers.

The authors concluded that, while the potential for bias in self-reporting may be a limitation of their study, their findings confirm that sleep problems and pain are common among patients with RA, and that both of these factors have a significant relationship with inflammatory markers.

Since such increases in inflammatory markers predict heightened disease activity in RA, relieving pain and alleviating sleep-related difficulties can potentially reduce the severity of RA. The authors say that further studies, inclusive of additional inflammatory markers, will help support a broader generalization of their findings.