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Abstract
Methods 300 Rheumatoid Arthritis (RA) patients were recruited for this study. All RA patients fulfilled the 2010 ACR-EULAR classification criteria for rheumatoid arthritis. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Pain severity was assessed by using the HAQ-pain scale .Depression was assessed by using Beck depression Inventory. Fatigue was assessed by using multidimensional assessment of fatigue scale. Anxiety was assessed by using Hamilton Anxiety Rating scale .Disease activity was assessed by using Disease activity score-28 (DAS-28) Functional outcome was assessed by using Modified Health Assessment Questionnaire (MHAQ) score .Radiological damage was evaluated according to Modified Larsen score .Results:-Sleep disturbances were prevalent in one hundred ninty six (65.3%) of the studied patients according to PSQI total score. On analysis of PSQI sleep components, sleep efficiency was the most commonly affected component. One hundred and fifty ( 50%) of patients their sleep efficiency was less than 65%.Poor sleep quality was associated with greater functional disability (p= .000). , higher disease activity (p=.000), higher levels of fatigue (p=.000), anxiety (p=.000), depression (p=.000) and pain (p=.000), however Logistic regression analysis showed that fibromyalgia , fatigue ,anxiety and hypertension are the most important factors that lead to sleep disturbance in RA.Conclusion:Sleep disturbances are prevalent among RA patients , with multiple factors contributing to it, but fibromyalgia , fatigue ,anxiety and hypertension were the strong predictors of poor sleep quality in RA patients. Assessment and management of sleep disturbances should be part of routine care of RA patients