Poor Sleep Tied to Greater Pain Interference in Early RA
Patients with early rheumatoid arthritis (RA) who experienced higher levels of sleep disturbances were more likely to have greater difficulties with daily activities because of pain 6 months later.
METHODOLOGY:
Researchers analyzed data from the Canadian Early Arthritis Cohort study between 2016 and 2023 to examine the association between sleep disturbances and pain interference with daily functioning in patients with early RA.
They included 502 patients (mean age, 56 years; 68% women; mean duration of disease, 5.4 months) who presented with joint symptoms for a maximum duration of 12 months.
Participants completed Patient-Reported Outcomes Measurement Information System measures at baseline and at subsequent follow-ups to assess sleep disturbance and pain interference they experienced over the past 7 days.
The sleep disturbance domain included questions regarding perceptions of sleep quality, depth, and restoration, and the pain interference domain included questions about how pain affected physical, mental, and social functioning.
TAKEAWAY:
At baseline, 80% and 44% of patients with early RA reported having mild to severe scores for pain interference and sleep disturbance, respectively.
Those who reported higher sleep disturbance reported greater subsequent pain interference at the 6-month follow-up, even after adjusting for covariates (adjusted β coefficient, 0.76; 95% CI, 0.44-1.09).
These findings were consistent across several sensitivity analyses, including adjustments for time-varying symptoms of depression and concurrent pain interference at baseline.
IN PRACTICE:
'Identification and early intervention in problematic sleep patterns may contribute to enhanced long-term pain outcomes,' the authors wrote.
SOURCE:
This study was led by Burcu Aydemir, PhD, Northwestern University Feinberg School of Medicine, Chicago. It was published online on May 12, 2025, in Arthritis Care and Research .
LIMITATIONS:
This study relied on patient-reported assessments for sleep and pain interference, which may have introduced bias. Although the study accounted for several important confounders, it likely did not eliminate all potential sources of bias from unmeasured confounding. Additionally, the study did not assess the impact of the duration of sleep disturbances, so it's unclear how persistent or temporary sleep issues can affect pain interference outcomes.
DISCLOSURES:
The Canadian Arthritis Cohort study received funding from Pfizer, AbbVie, Hoffman La Roche, and other sources. Some authors reported receiving research support, grants, consulting fees, payments, or honoraria from; holding stocks of; or having other ties with various sources, including the funding agencies.
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