Nonsteroidal antiinflammatory drug therapy in rheumatoid arthritis patients. Lack of association between clinical improvement and effects on sleep.
Thirteen patients with rheumatoid arthritis (mean +/- SD age 55.8 +/- 10.5 years) received 20 mg of tenoxicam daily for 90 days following a 3-7 day "washout" period and 4 days of placebo treatment. Clinical evaluations were conducted at the end of the washout period and at monthly intervals thereafter. All-night polysomnography was performed in a sleep laboratory during the last 2 days of placebo treatment and on days 13, 14, 89, and 90 of tenoxicam treatment. Although there was improvement in the patients' clinical condition, there were no treatment-related changes in any of the sleep parameters. Eight of the 13 patients, however, were found to have primary sleep disorders. Four had periodic leg movements during sleep, 3 had sleep apneas, and 1 had a combination of both disorders. The implications of these findings in the treatment of sleep disorders in patients with rheumatoid arthritis are discussed.
Lavie
P
P
Department of Rheumatology, Rambam Medical Center, Haifa, Israel.
Nahir
M
M
Lorber
M
M
Scharf
Y
Y
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D010894:Piroxicam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012148:Restless Legs Syndrome / Q000150:complications; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000150:complications; D012893:Sleep Wake Disorders / Q000150:complications*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; C032801:tenoxicam