Treating Sleep Problems Early May Reduce Pain in Rheumatoid Arthritis, suggests study

Rheumatoid arthritis is a long-standing inflammatory condition typically associated with fatigue, sleep disturbance, and chronic pain. Although medical management has improved considerably, pain continues to be a chief complaint among patients with RA. Poor sleep has been associated with increased pain perception in chronic diseases, but little research has addressed this relationship over a longitudinal period, especially in early RA. This investigation aimed to test whether sleep quality might predict pain interference with daily functioning in the long term, with the potential for informing more optimal pain management in clinical practice.

Data were gathered on 502 adults with early RA—diagnosed as having symptoms of 12 months or less in their joints—enrolled between 2016 and 2023 in the Canadian Early Arthritis Cohort. Patients received clinical assessment and filled out PROMIS-29 (Patient-Reported Outcomes Measurement Information System) questionnaires on five occasions: baseline (0 months), 6 months, 12 months, 18 months, and 24 months.

Sleep disturbance was targeted as the primary predictor and pain interference as the key outcome. Linear mixed effects regression models were employed to estimate the associations after controlling for age, sex, body mass index, education, income, smoking status, comorbidities, disease activity, treatment, and depression. A lagged analysis model was applied to analyze whether sleep disturbance at every time point predicted 6-month follow-up pain interference.

Results

• Study population: 502 early RA patients (symptoms ≤12 months)

• Demographics: 68% female, 81% White, mean age 56 years (SD = 14)

• Disease duration at baseline: 5.4 months (SD = 2.9)

• Measures used: PROMIS-29 measures of sleep disturbance and pain interference

• Analysis model: Linear mixed effects, controlled for several confounders

• Outcome: Low-quality sleep at a specific time point predicted higher pain interference scores 6 months later

• Significance: The correlation held after controlling for demographics, clinical factors, and mental health

The research concludes that the early recognition and treatment of sleep disturbances can be an essential step in enhancing pain outcomes among patients with early rheumatoid arthritis. Providers should include assessment for sleep into standard care for patients with a new diagnosis of RA, as sleep treatments that enhance quality can become extremely significant in reducing long-term pain-associated functional impairment. This research highlights the often-overlooked role of sleep in the treatment of chronic inflammatory conditions like RA and supports an integrated model of care.

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