Sleep Problems Common Among Patients With Psoriatic Arthritis

The prevalence of poor sleep quality in patients with psoriatic arthritis (PsA) is 72.9%, according to a meta-analysis of six studies that used the Pittsburgh Sleep Quality Index. The finding was included among results from a systematic review and meta-analysis published online ahead of print in The Journal of Rheumatology.

In all, the investigation spanned 36 studies that focused on the relationship between PsA and sleep problems. Overall, the prevalence of self-reported sleep problems in the studies ranged from 30% to 85%, reported corresponding author LM Perez-Chada, MD, MMSc, of Harvard Medical School’s Brigham and Women’s Hospital, Boston, Massachusetts, and study coauthors.

The 72.9% rate of poor sleep among patients with PsA in studies using the Pittsburgh Sleep Quality Index was significantly higher than the 26.9% rate in health control subjects, according to the study. However, it did not significantly differ from a rate of 59.8% reported in patients with psoriasis.

Anxiety, pain, erythrocyte sedimentation rate, depression, fatigue, physical function, and tender/swollen joint count were predictors of sleep problems in patients with PsA, the study found. Tumor necrosis factor (TNF)-inhibitors, guselkumab, and the Janus kinase (JAK) inhibitor filgotinib, on the other hand, were associated with improved sleep.

Sleep disturbance ranked among the top 4health-related quality of life domains affected by PsA, researchers reported.

“In summary, poor sleep quality is prevalent in patients with PsA,” the authors wrote. “Future studies should validate self-reported sleep measures in PsA, explore how sleep quality relates to PsA disease activity and symptoms using both objective and subjective sleep measures, assess the efficacy of strategies to manage sleep problems, and the effects of such management on symptoms and disease signs in patients with PsA.”

Reference: 
Grant C, Woodbury M, Skougaard M, et al. Sleep problems in patients with psoriatic arthritis: a systematic literature review and meta-analysis. J Rheumatol. Published online May 1, 2023. doi: 10.3899/jrheum.2022-1169