Introduction/objectives This study provides a novel comparison of sleep disturbances and associated risk factors in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), and assesses the correlation between the Multidimensional Health Assessment Questionnaire (MDHAQ) and the Pittsburgh Sleep Quality Index (PSQI) in detecting poor sleep. Method We performed a cross-sectional study of 313 adult patients included in the PolNorRHEUMA registry. Demographics, disease activity, pain and other clinical variables were recorded. Patients completed a PSQI, with scores higher than 5 indicating poor sleep, and an MDHAQ, including queries concerning sleep, anxiety, depression, stress. Results This study included 129 patients with RA, 81 with PsA and 103 with axSpA. The median disease activity scores corresponded to remission or low disease activity. The prevalence of poor sleep was 61.5% in PsA, 63.7% in RA, to 66.7% in axSpA; no significant differences in PSQI total scores or sleep domains were identified. Independent risk factors for poor sleep were female sex in RA, older age and anxiety in PsA. Strong correlation coefficients between the MDHAQ sleep-related question and PSQI score were observed: 0.53 for RA, 0.65 for PsA and 0.55 for axSpA (p < 0.01). In the linear regression analysis, a significant association was maintained in RA and axSpA. Conclusions Our research confirms a high prevalence of sleep disturbances in RA, axSpA, and PsA, despite well-controlled disease activity, highlighting the role of non-inflammatory factors in the pathophysiology. The MDHAQ could serve as a screening tool for identifying poor sleep quality. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points •Poor sleep is prevalent among patients with RA, axSpA and PsA •Prevalence of sleep disturbances is high despite well-controlled disease activity. •Risk factors for poor sleep identified in this study include female sex in RA, and older age and anxiety in PsA. •The MDHAQ could serve as a screening tool for identifying patients with poor sleep quality, needing further evaluation. </entry> </row> </tbody> </tgroup> </Table>

Sleep disorders in RA, axSpA and PsA are common despite good disease activity control—direct comparison of sleep quality and its risk factors using MDHAQ and PSQI

期刊论文
发表日期：

2026年1月19日

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Dagna Polak,
Monika Kolasińska,
Mateusz Wilk,
Łukasz Dyczek,
Mariusz Korkosz,
Zofia Guła

摘要

Introduction/objectives

This study provides a novel comparison of sleep disturbances and associated risk factors in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), and assesses the correlation between the Multidimensional Health Assessment Questionnaire (MDHAQ) and the Pittsburgh Sleep Quality Index (PSQI) in detecting poor sleep.

Method

We performed a cross-sectional study of 313 adult patients included in the PolNorRHEUMA registry. Demographics, disease activity, pain and other clinical variables were recorded. Patients completed a PSQI, with scores higher than 5 indicating poor sleep, and an MDHAQ, including queries concerning sleep, anxiety, depression, stress.

Results

This study included 129 patients with RA, 81 with PsA and 103 with axSpA. The median disease activity scores corresponded to remission or low disease activity. The prevalence of poor sleep was 61.5% in PsA, 63.7% in RA, to 66.7% in axSpA; no significant differences in PSQI total scores or sleep domains were identified. Independent risk factors for poor sleep were female sex in RA, older age and anxiety in PsA. Strong correlation coefficients between the MDHAQ sleep-related question and PSQI score were observed: 0.53 for RA, 0.65 for PsA and 0.55 for axSpA (p < 0.01). In the linear regression analysis, a significant association was maintained in RA and axSpA.

Conclusions

Our research confirms a high prevalence of sleep disturbances in RA, axSpA, and PsA, despite well-controlled disease activity, highlighting the role of non-inflammatory factors in the pathophysiology. The MDHAQ could serve as a screening tool for identifying poor sleep quality.

Key Points

•Poor sleep is prevalent among patients with RA, axSpA and PsA

•Prevalence of sleep disturbances is high despite well-controlled disease activity.

•Risk factors for poor sleep identified in this study include female sex in RA, and older age and anxiety in PsA.

•The MDHAQ could serve as a screening tool for identifying patients with poor sleep quality, needing further evaluation.