Session Information
Date: Sunday, November 8, 2015
Title: Sjögren's Syndrome Poster I: Clinical Insights into Sjögren's Syndrome
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: EULAR Sjögren’s
syndrome Patient-Reported Index (ESSPRI) is an index to evaluate symptom
severity and recommended as an efficacy measure for clinical trials in primary Sjögren’s
syndrome (pSS) patients. The prevalence of sleep disturbance has reportedly
increased in pSS and sleep disturbance could affect pSS symptom severity.
However, the association between insomnia and ESSPRI in pSS has not been
reported.
Methods: Forty-three pSS
patients, who fulfilled the American-European Consensus Group (AECG) criteria,
consecutively were enrolled. The patients completed questionnaires on quality
of life (EQ5D), ESSPRI, insomnia (Insomnia Severity Index, ISI), sleep quality
(Pittsburgh Sleep Quality index, PSQI), fatigue (Fatigue Severity Score, FSS), and
depression (Korean Beck Depression Inventory, KBDI). Additionally, they were
evaluated by 100 mm-VAS scale for patient global assessment (PGA), oral or eye
dryness, eyeball pain, and anxiety. Data were also collected on demographic,
clinical, and laboratory variables.
Results: Among 43 pSS
patients, 10 (23.3%) had clinical insomnia (ISI>14) and 24 (55.8%) had no sleep
disturbance (ISI<8). Patients with clinical insomnia had significantly higher
ESSPRI (p=0.005), scores for FSS and KBDI (both p<0.01), and
VAS levels for dry eye, eyeball pain, anxiety, and PGA (all p<0.05)
than those without clinical insomnia. Furthermore, they had significantly lower
EQ5D score (p=0.005). ISI was significantly correlated with ESSPRI,
scores of EQ5D, FSS, and KBDI, and VAS levels of oral or eye dryness, nocturnal
xerostomia, eyeball pain, anxiety, and PGA (all p<0.05). The
distribution of ISI was significantly different according to tertiles of ESSPRI
(p<0.05, Figure 1). When high levels were defined by the upper
tertile of each continuous variables or according to the cuff off points for
ISI, KBDI, and FSS, a logistic regression analysis showed that high ESSPRI was significantly
associated with high PGA (p<0.01, OR 10.3) and clinical insomnia (p<0.05,
OR 12.5, Table 1).
Conclusion: Our results suggest
that clinical insomnia is able to independently affect ESSPRI levels and insomnia
symptom might be a target to improve ESSPRI levels in pSS patients.
|
Table 1. Logistic regression analysis of the association of between high ESSPRI (defined as the highest tertile) and clinical insomnia |
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|
|
Beta |
Odds ratio |
95% CI |
P value |
|
High PGA* for pSS |
2.330 |
10.28 |
1.88 – 56.16 |
0.007 |
|
Clinical insomnia |
2.522 |
12.45 |
1.72 – 89.94 |
0.012 |
|
*, high PGA was defined as the highest tertile. |
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Figure
1. The association between Insomnia Severity Index (ISI) and ESSPRI. (A) ISI
scores increased according to tertiles of ESSPRI in pSS patients. P value was
calculated by Kruskal-Wallis test. (B) Scatter plot showed a positive
correlation between ESSPRI and ISI in pSS patients. P value was calculated by
Spearman’s correlation.
To cite this abstract in AMA style:
Hur J, Chung SW, Ha YJ, Kang EH, Song YW, Lee YJ. Association Between Insomnia and EULAR Sjögren’s Syndrome Patient-Reported Index in Korean Patients with Primary Sjögren’s Syndrome [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/association-between-insomnia-and-eular-sjogrens-syndrome-patient-reported-index-in-korean-patients-with-primary-sjogrens-syndrome/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-insomnia-and-eular-sjogrens-syndrome-patient-reported-index-in-korean-patients-with-primary-sjogrens-syndrome/