Sleep problems in ankylosing spondylitis: polysomnographic pattern and disease related variables

ABSTRACT

To identify polysomnographic sleep pattern and its correlations with disease specific variables as well as fatigue, depression and quality of life in patients with ankylosing spondylitis. Polysomnographic [PSG] sleep assessment was done for 30 males including 10 healthy subjects and 20 patients with ankylosing spondylitis [AS]. Sleep quality, fatigue and depression were evaluated. Disease specific variables such as disease activity, functional disability, global well being and quality of life were recorded. Ninety percentage of AS patients were classified as poor sleepers. In comparison to controls, patients with AS experienced prolonged sleep latency, lessened sleep efficiency, increased stages I%, II%, deficient SWS%, higher arousal and periodic leg movement indices in a significant manner. Meanwhile obstructive sleep apnea was not a significant finding. Significant correlations were detected between most of the PSG parameters as well as sleep quality index on one hand and different disease specific variables, fatigue, pain, quality of life on the other hand but not with depressive symptoms. Disease activity, fatigue and quality of life were significantly associated with most of PSG sleep components on the multiple regression analysis model. AS patients differ negatively in their sleep from normal population both in quantity and quality. Our findings suggest that multiple factors are associated with PSG sleep disturbances including disease activity, fatigue and quality of life. While treating patients, it is important to question sleep disorders followed by the performance of PSG in order to optimize the management of patients with AS