Aim of the work: to study sleep quality in RA patients and its effects on health related quality of life.

Subjects and methods: This study was carried out on 30 RA patients and 30 healthy controls. RA disease activity was measured by DAS-28. All patients were subjected to full history taking, clinical examination and laboratory investigations including: CBC, ESR, CRP, RF, anti-CCP antibodies, liver and kidney functions. Quality of life was evaluated by Health Assessment Questionnaire –Disability Index (HAQ-DI). Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI). Anxiety and depression was evaluated by Hospital Anxiety and Depression Scale (HADS). Pain was evaluated by visual analogue scale (VAS).
Results: Our study found that PSQI was higher in RA patients compared to controls without statistical significant difference. Depression and Anxiety were significantly higher compared to controls. We also found that RA patients with poor sleep had RF, Anti CCP, DAS28, ESR, CRP, depression, anxiety VAS and HAQ were significantly higher compared to good sleepers. Also, RA with a PSQI score ≥5 (poor sleepers) were significantly having DMARDs more frequently than those with good sleep. HRQoL also associated with sleep quality and its impaired was affected by physical pain or function.
Conclusion: We observed that 73% of RA patients had poor sleep quality compared with healthy controls affecting their HRQoL. We found essential need for systemic psychiatric screening and management to help RA patients get rid of their sleep problems and improve their HRQoL.