Sleep and fatigue and the relationship to pain, disease activity and quality of life in juvenile idiopathic arthritis and juvenile dermatomyositis

Rheumatology, 08/30/2011

Aviel YB et al. – Sleep disturbance and fatigue are prevalent among children with different rheumatic diseases. Sleep disturbance and fatigue are strongly associated with increased pain and decreased quality of life. Strategies aimed at improving sleep and reducing fatigue should be studied as possible ways of improving quality of life for children with rheumatic illness.

Methods

  • 155 patients (115 JIA, 40 JDM) randomly sampled and mailed questionnaires
  • Sleep disturbance assessed by sleep self–report (SSR) and children's sleep habits questionnaire (CSHQ)
  • Fatigue, pain and function assessed by the paediatric quality of life inventory (PedsQL) and disease activity by visual analogue scales (VASs)
  • Joint counts self–reported

Results

  • 81% responded
  • 44% reported disturbed sleep (CSHQ>41)
  • No differences between disease groups
  • Poor reported sleep (SSR) highly correlated with PedsQL fatigue (r=0.56, P<0.0001)
  • Fatigue was highly negatively correlated with quality of life (r=–0.77, P<0.0001)
  • Worst pain intensity in last week correlated to sleep disturbance (r=0.32, P=0.0005)
  • Fatigue was associated with prednisone and DMARD use

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