Turkish Journal of Physical Medicine and Rehabilitation 2009 , Vol 55 , Num 3

Evaluation of Rheumatoid Arthritis Patients with Pittsburgh Sleep Quality Index

İlknur Yiğit Gökçe 1 ,Mehmet Ünlü 2 ,Özlem Solak 3 ,Ümit Dündar 3 ,Ümit Seçil Demirdal 1 ,Fatma Fidan 2
1 Afyon Kocatepe Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Afyonkarahisar
2 Afyon Kocatepe Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Afyonkarahisar
3 Department of Physical Medicine and Rehabilitation, Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar, Turkey
4 Afyon Kocatepe Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Afyonkarahisar, Türkiye

Objective: To evaluate the sleep quality in rheumatoid arthritis (RA) patients using Pittsburgh Sleep Quality Index (PSQI) and to determine the factors that may affect sleep quality.


Materials and Methods: Fifty five RA patients who fullfilled American College of Rheumatology diagnosis criteria for RA and 20 healthy persons were included in the study. Demographic data of each subject, the disease duration and DAS 28 scores for each RA patient were recorded. 


Results: There was no difference between the two groups in  mean age and sex (p>0.05). The mean disease duration of RA patients was 6.3±6.5 years and the mean DAS 28 score was 3.5±1.3. The mean Global PSQI score was found significantly high in RA group compared to control group. Sleep quality was assessed as poor (global score ≥5) in 35 (63.6%) RA patients and in 5 (25.0%) subjects in the control group (p=0.003). The mean Global PSQI score was higher in RA patients who were not administered TNF-a blocker compared to those who were administered (respectively 6.9±3.9, 5.2±2.6, p=0.326), but the difference was not statistically significant. On the other hand, a significant correlation was found between Global PSQI score and DAS 28 score (r=0.270 p=0.046).


Conclusion: The sleep quality of RA patients is worse than the healthy persons. PSQI questionnaire may be used to evaluate sleep quality in RA patients. It is reported that biologic agent treatment can have some benefits in RA patients with sleep disturbances. Further researches with large samples should be held to investigate the effects of biologic agents on sleep quality. 

Keywords : Rheumatoid arthritis, Pittsburgh Sleep Quality Index