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Sleep Disturbance in Rheumatic Disease

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Psychosocial Factors in Arthritis
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Abstract

Poor sleep quality and sleep disturbances are commonly reported by patients with arthritis and with systemic lupus erythematosus (SLE). Objectively measured sleep in patients with arthritis and SLE indicate that sleep architecture appears to be similar to healthy controls, but arousals and awakenings are frequent. Sleep disturbances in arthritis are associated with a variety of factors, including disease activity, pain, and depressive symptoms. These associations are complex and are likely bidirectional. Sleep disturbances can lead to increases in fatigue and contribute to functional disability. Pharmacological treatments for sleep such as benzodiazepine and nonbenzodiazepine hypnotics appear to provide short term improvements in sleep in patients with arthritis. Several nonpharmacological alternatives for improving sleep have been explored in patients with arthritis – aerobic and resistance exercise, yoga, biofeedback, and cognitive-behavioral treatment for insomnia (CBT-I). Available studies suggest that exercise and yoga may improve sleep disturbances and sleep quality and that biofeedback may be a beneficial adjunctive treatment to exercise. Recent investigations of the utility of CBT-I in patients with osteoarthritis found both short-term and long-term improvements in sleep quality. Brief behavioral treatment for insomnia (BBTI) may be a viable alternative to CBT-I for patient with activity limitations because it requires minimal in-person sessions.

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Correspondence to Faith S. Luyster PhD .

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Luyster, F.S. (2016). Sleep Disturbance in Rheumatic Disease. In: Nicassio, P. (eds) Psychosocial Factors in Arthritis. Springer, Cham. https://doi.org/10.1007/978-3-319-22858-7_9

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