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Osteoarthritis and Sleep: The Johnston County Osteoarthritis Project
KELLI D. ALLEN, JORDAN B. RENNER, BRENDA DEVELLIS, CHARLES G. HELMICK, and JOANNE M. JORDAN
ABSTRACT. Methods. Participants (N = 2682, 28% with symptomatic hip or knee OA) were from the Johnston County Osteoarthritis Project. Six sleep variables were grouped into 2 categories: insomnia (trouble falling asleep, trouble staying asleep, or waking early) and insufficient sleep (daytime sleepiness, not enough sleep, or not feeling rested). The presence of any sleep problem (insomnia or insufficient sleep) was also assessed, as were annual frequency and cumulative days of sleep problems. Adjusted models examined associations of symptomatic OA with sleep problems controlling for demographic characteristics, obesity, self-reported health, and depressive symptoms. Results. Symptomatic hip or knee OA was associated with increased odds of any sleep problem (odds ratio 1.25, 95% confidence interval 1.02–1.54), insomnia (OR 1.29, 95% CI 1.07–1.56), and insufficient sleep (OR 1.35, 95% CI 1.12–1.62) in adjusted models. Among participants with sleep problems, those with symptomatic OA reported higher median numbers of annual and cumulative days of insomnia and insufficient sleep, although these associations were not statistically significant in adjusted models. Conclusion. Symptomatic hip and knee OA are significantly associated with sleep problems, independent of other factors related to sleep difficulties, including self-rated health and depression. Patients with OA should be regularly screened for sleep disturbance as part of routine care. (First Release May 15 2008; J Rheumatol 2008;35:1102-7) Key Indexing Terms:
SLEEP DISTURBANCES
From the Health Services Research and Development Service, Durham Veterans Affairs Medical Center; Department of Medicine, Duke University Medical Center, Durham, North Carolina; Thurston Arthritis Research Center, Department of Radiology, Department of Health Behavior and Health Education, Department of Psychology, Department of Medicine, and Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Supported by the Centers for Disease Control and Prevention/Association of Schools of Public Health cooperative agreements S1734 and S3486 (JMJ, JBR), the NIAMS Multipurpose Arthritis and Musculoskeletal Disease Center grant 5-P60-AR30701 (JMJ, JBR), and the NIAMS Multidisciplinary Clinical Research Center grant 5 P60 AR49465-03 (JMJ, JBR). K.D. Allen, PhD, Health Services Research and Development Service, Durham Veterans Affairs Medical Center, Department of Medicine, Duke University Medical Center; J.B. Renner, MD, Thurston Arthritis Research Center, Department of Radiology, University of North Carolina at Chapel Hill; B. DeVellis, PhD, Thurston Arthritis Research Center, Department of Health Behavior and Health Education, Department of Psychology, University of North Carolina at Chapel Hill; C.G. Helmick, MD, Centers for Disease Control and Prevention; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, Department of Medicine, Department of Orthopaedics, University of North Carolina at Chapel Hill. Address reprint requests to Dr. J.M. Jordan, 3300 Thurston-Bowles, Box 7280, University of North Carolina, Chapel Hill, NC 27599. E-mail: joanne_jordan@med.unc.edu Accepted for publication January 24, 2008. |
