Background/Purpose: Juvenile idiopathic arthritis is a broad term that describes a clinically heterogeneous group of arthritis of unknown cause, which begin before 16 years of age. Sleep problems are common among children with chronic illnesses such as JIA. However, little is known about the frequency and severity of sleep disturbance(s) and the factors that are associated with sleep problems in children with JIA. The aims of this study were to primarily investigate sleep quality and to secondarily examine possible associations of pain, disease activity, sleep disturbance in Turkish children and adolescent with JIA.

Methods: 96 patients with JIA (age range 8-18) participated in this study. Disease activity was assessed with The Juvenile Arthritis Disease Activity Score-27 (JADAS27). Pain severity was evaluated with a 100-mm Visual Analog scale (VAS). Sleep quality was evaluated with Pittsburgh Sleep Quality Index (PSQI). The PSQI is a self-rating questionnaire resulting in a global score between 0 and 21, which consists of seven subscores (sleep quality, sleep latency, Sleep efficiency, daytime dysfunction, sleep disturbance, use of sleeping medication, sleep duration). A global PSQI score above 5 indicates poor sleep.

Results: A total of 96 eligible patients with JIA (61 female, 35 male) were enrolled including 42 (43.8%) with polyarticular onset, 33 (34.8%) with oligoarticular subtype, 14 (14.6%) with systemic onset and 7 (7.3%) with other subtypes. The mean of age, duration of sleep and pain severity was 12.93±3.36, 8.43±1.59 and 23.80±24.82, respectively. 39.6% of participants were poor sleepers. Table 1 shows comparisons of the results of JADAS and VAS pain in patients with good/poor sleep quality groups. JADAS and VAS-pain were statistically significant worse in patients with poor sleep than in patients with good sleep (p<0.05). 96.1% of patients have reported that they have experience of sleep disturbance (65.6% of them; less than once a week, 30.2% of them; once or twice a week, 1% of them; three or more time week). Sleep quality was very good only for 29.2% of them. 84.4% of them have reported they sleep >7 hours. 66.7% of participants reported needed more than 15 minutes to fall asleep each night (sleep latency). Sleep efficiency was found as >85% for almost all patients.

Conclusion: The results of this study suggest that poor sleep are significant widespread in Turkish children and adolescent with JIA and poor sleep quality is associated with greater pain severity and disease activity among patients with JIA. Future research should investigate whether reducement in pain and disease activity can improve sleep quality in patients with JIA Table 1. Comparisons of the results of JADAS and VAS pain in patients with good/poor sleep quality groups 

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/sleep-and-its-relationship-to-pain-and-disease-activity-in-turkish-children-and-adolescent-with-juvenile-idiopathic-arthritis/