Association of the sleep quality with pain, radiological damage, functional status and depressive symptoms in patients with knee osteoarthritis

Abstract

Objective: The aim of this study is to evaluate the sleep quality and relationship between the sleep quality with disease-related variables, pain, functional status, radio­logical damage and the psychological status in patients with Osteoarthritis (OA). Methods: Fifty two patients diagnosed with OA and 35 healthy control subjects were enrolled in the study. The demographic characteristics of the patients such as age, education level, and marital status were recorded. Dis­ease related disability were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Generalized pain, generalized fatigue and knee pain were assessed with the Visual Analogue Scale (VAS). Psychological status were evaluated with the Hos­pital Anxiety Depression Scale. The radiological grade of knee OA was evaluated according to the Kellgren Law­rence score. For the evaluation of the sleep quality, the OA and control groups were assessed with the help of the Pittsburgh Sleep Quality Index (PSQI). Results: The patients with OA had significantly higher scores in the subjective sleep quality, sleep latency, habit­ual sleep efficiency and total PSQI score compared to the healthy control group (p

Keywords

• Knee osteoarthritis, sleep quality, pain, ra­diological grade, depression

Diz osteoartritli hastalarda uyku kalitesinin ağrı, radyolojik hasar, fonksiyonel durum ve depresif semptomlar ile ilişkisi

Abstract

Amaç: Bu çalışmanın amacı diz osteoartriti (OA) tanılı hastalarda uyku kalitesini değerlendirmek ve uyku kalitesi ile klinik parametreler, ağrı, fonksiyonel durum, radyolojik hasar ve psikolojik durum arasındaki ilişkiyi incelemektir. Yöntemler: Diz osteoartriti tanılı 52 hasta ve 35 sağlık­lı gönüllü çalışmaya dahil edildi. Hastaların yaş, eğitim seviyesi, medeni durumu gibi demografik özellikleri kay­dedildi. Hastalıkla ilişkili yeti yitimi, Western Ontario ve McMaster Üniversitesi Osteoartrit indeksi (WOMAC) ile değerlendirildi. Genel ağrı, genel yorgunluk ve diz ağrısı seviyesi görsel analog skala ile değerlendirildi. Psikolojik durum hastane anksiyete depresyon skalası ile ölçüldü. Diz osteoartritinin radyolojik evresi Kellgren Lawrence skoruna göre hesaplandı. Hasta ve kontrol grubunun uyku kalitesi, Pittsburgh uyku kalitesi indeksi (PUKİ) yar­dımıyla değerlendirildi. Bulgular: Diz osteoartriti olan hastalarda, öznel uyku ka­litesi, uykuya dalma süresi, alışılmış uyku etkinliği ve total PUKİ skoru kontrol grubuna göre anlamlı olarak yüksekti (p

Keywords

• Diz osteoartriti, uyku kalitesi, ağrı, radyolojik evre, depresyon

References

1. Osteoarthritis. San Diego: Arthritis Foundation San Di- ego Area Chapter; 2003.
2. Hawker GA, Mian S, Bednis K, Stanaitis I.Osteoarthritis year 2010 in review: non-pharmacologic therapy. Os- teoarthritis Cartilage 2011;19:366-374.
3. Milne AD, Evans NA, Stanish WD. Nonoperative man- agement of knee osteoarthritis: Diagnosis, behavior modification, and pharmacologic options. Women’s Health in Primary Care 2000;3:841-846.
4. Drewes AM, Nielsen KD, Hansen B, et al. Svendsen L. A longitudinal study of clinical symptoms and sleep parameters in rheumatoid arthritis. Rheumatology (Oxford) 2000;39:1287-1289.
5. Moldofsky H, Lue FA, Smythe HA. Alpha EEG sleep and morning symptoms in rheumatoid arthritis. J Rheumatol 1983;10:373-379.
6. Taylor-Gjevre RM, Gjevre JA, Nair B, et al. Compo- nents of Sleep Quality and Sleep Fragmentation in Rheumatoid Arthritis and Osteoarthritis. Musculoskel- etal Care 2011; doi: 10.1002/msc.208.
7. Wilcox S, Brenes GA, Levine D, et al. Factors related to sleep disturbance in older adults experiencing knee pain or knee pain with radiographic evidence of knee osteoarthritis. J Am Geriatr Soc 2000;48:1241-1251.
8. Altman R, Asch E, Bloch D et al. Development of cri- teria for the classification and reporting of osteoar- thritis. Classification of osteoarthritis of the knee. Di- agnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986;29:1039-1049.

9. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957;16:494-502.
10. Bellamy N, Buchanan WW, Goldsmith CH et al. Vali- dation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988;15:1833-1840.
11. Zigmond AS, Snaith PR. The hospital anxiety and de- pression scale. Acta Psychiatr Scand 1983;67: 361- 370.
12. Aydemir O, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version of hospital anxiety and de- pression scale. Turk Psikiyatri Derg 1997;8:280-287.
13. Buysse DJ, Reynolds CF, Monk TH et al. The Pitts- burgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
14. Ağargün MY, Kara H, Anlar Ö. Pittsburgh uyku kalitesi indeksi’nin geçerliği ve güvenirliği. Türk Psikiyatri Der- gisi 1996;7:107-115.
15. Murphy SL, Lyden AK, Phillips K, et al. Association between pain, radiographic severity, and centrally- mediated symptoms in women with knee osteoarthri- tis. Arthritis Care Res 2011;63:1543-1549.
16. Allen KD, Renner JB, DeVellis B et al. Osteoarthritis and sleep: the Johnston County Osteoarthritis Proj- ect. J Rheumatol 2008;35:1102e1107.
17. Bedson J, Croft P. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculo- skelet Disord 2008;9:116.
18. Hannan MT, Felson DT, Pincus T. Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatol 2000;27:1513-1517.
19. Hadler NM. Knee pain is the malady not osteoarthritis. Ann Intern Med 1992;116:598-599.
20. Murphy SL, Lyden AK, Phillips K et al. Association be- tween pain, radiographic severity, and centrally-me- diated symptoms in women with knee osteoarthritis. Arthritis Care Res 2011;63:1543-1549.
21. Massardo L, Watt I, Cushnaghan J, Dieppe P. Osteo- arthritis of the knee joint: An eight year prospective study. Ann Rheum Dis 1989;48:893-897.
22. Power JD, Perruccio AV, Badley EM. Pain as a me- diator of sleep problems in arthritis and other chronic conditions. Arthritis Care Res 2005;53:911-919.
23. Foley DJ, Monjan AA, Brown SL et al. Sleep com- plaints among elderly persons: An epidemiologic study of three communities. Sleep 1995;18:425-432.
24. Wolfe F, Michaud K, Li T. Sleep disturbance in pa- tients with rheumatoid arthritis: evaluation by medi- cal outcomes study and visual analog sleep scales. J Rheumatol 2006;33:194219-51.
25. Nicassio PM, Wallston KA. Longitudinal relationships among pain, sleep problems, and depression in rheu- matoid arthritis. J Abnorm Psychol 1992;101:514-20.
26. Kim KW, Han JW, Cho HJ et al. Association between comorbid depression and osteoarthritis symptom se- verity in patients with knee osteoarthritis. J Bone Joint Surg Am 2011;93:556-563.
27. Wolfe F. Determinants of WOMAC function, pain and stiffness scores: evidence for the role of low back pain, symptom counts, fatigue and depression in osteoarthritis, rheumatoid arthritis and fibromyalgia. Rheumatology (Oxford) 1999;38:355e361.