title: Sleep in rheumatic diseases and other painful conditions.
abstract: Insufficient sleep is an under-recognized public health problem that is projected to increase in the next decade as the US population ages. Chronic insomnia alone impacts 10% to 15% of adults. Epidemiologic data indicate that pain, fatigue, and mood disturbance are common correlates of persistent insomnia. Rates of most sleep disorders are substantially elevated in rheumatologic diseases, with chronic insomnia impacting at least 50% of patients. Clinicians treating patients with rheumatologic disorders should screen for sleep disorders and possess a basic knowledge of sleep physiology and empirically based intervention approaches. Sleep disturbances occurring within the context of chronic medical illnesses, including rheumatologic diseases, do not typically respond to primary disease and/or pain management interventions. Identification of co-occurring sleep disorders followed by aggressive treatment is recommended and has the potential to improve quality of life, ameliorate pain, and improve psychosocial adaptation to the primary illness. In this report, we briefly highlight that sleep disturbance increases risk for both comorbidities and symptoms associated with rheumatologic diseases, we identify specific sleep disorders commonly encountered in rheumatologic populations, and we discuss pharmacologic and behavioral treatment approaches for the most common sleep disorder observed in rheumatologic conditions, chronic insomnia.
authors: Luis F. Buenaver, PhD Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 1-108, Baltimore, MD 21287, USA. lbuenav1@jhmi.edu.
authors: Luis F
authors: LF
authors: Buenaver
authors: Michael T
authors: MT
authors: Smith
references: Acta Paediatr. 1999 Oct;88(10):1119-24
references: 10565460
references: Brain Res Bull. 2005 Jan 30;64(6):471-9
references: 15639542
references: J Psychosom Res. 2004 May;56(5):543-8
references: 15172211
references: Biol Psychiatry. 1996 Mar 15;39(6):411-8
references: 8679786
references: Diabetologia. 2005 Feb;48(2):235-41
references: 15645205
references: Nature. 2005 Oct 27;437(7063):1264-71
references: 16251951
references: Circulation. 2005 Feb 8;111(5):614-21
references: 15699282
references: Drugs Aging. 2005;22(9):749-65
references: 16156679
references: J Gen Intern Med. 2000 Sep;15(9):659-66
references: 11029681
references: Arch Intern Med. 2005 Nov 28;165(21):2527-35
references: 16314551
references: J Rheumatol. 1997 Nov;24(11):2158-61
references: 9375877
references: Electroencephalogr Clin Neurophysiol. 1991 Oct;79(4):271-6
references: 1717231
references: Clin Exp Rheumatol. 2001 Sep-Oct;19(5):509-14
references: 11579709
references: Arthritis Rheum. 1994 Jan;37(1):41-9
references: 8129763
references: Clin Exp Rheumatol. 1997 Jan-Feb;15(1):71-4
references: 9093776
references: J Clin Endocrinol Metab. 2001 Mar;86(3):1034-9
references: 11238482
references: Behav Res Ther. 2002 Mar;40(3):267-77
references: 11863237
references: Sleep. 2007 Apr;30(4):494-505
references: 17520794
references: Psychosomatics. 2000 Mar-Apr;41(2):104-13
references: 10749947
references: Br J Rheumatol. 1998 Aug;37(8):889-94
references: 9734681
references: Neuron. 2003 Feb 20;37(4):563-76
references: 12597855
references: Sleep. 2003 Nov 1;26(7):793-9
references: 14655910
references: JAMA. 2001 Apr 11;285(14):1856-64
references: 11308399
references: Lancet. 1999 Oct 23;354(9188):1435-9
references: 10543671
references: J Arthroplasty. 2003 Dec;18(8):1044-7
references: 14658110
references: Clin Psychol Rev. 2005 Jul;25(5):559-92
references: 15970367
references: Br J Rheumatol. 1994 Jan;33(1):60-3
references: 8162461
references: Clin Rheumatol. 2000;19(1):9-13
references: 10752492
references: FASEB J. 1996 Apr;10(5):643-53
references: 8621064
references: Am J Psychiatry. 2002 Jan;159(1):5-11
references: 11772681
references: Sleep Med Rev. 2004 Apr;8(2):119-32
references: 15033151
references: Rheum Dis Clin North Am. 1989 Feb;15(1):91-103
references: 2644681
references: Sleep. 2006 Nov;29(11):1415-9
references: 17162987
references: Science. 2001 Nov 2;294(5544):1052-7
references: 11691983
references: JAMA. 2004 Nov 17;292(19):2388-95
references: 15547167
references: J Clin Endocrinol Metab. 2004 May;89(5):2119-26
references: 15126529
references: Behav Res Ther. 2005 Dec;43(12):1611-30
references: 16239154
references: Pain. 1996 Dec;68(2-3):363-8
references: 9121825
references: Arthritis Rheum. 1994 Jan;37(1):32-40
references: 8129762
references: J Pineal Res. 2006 Jan;40(1):98-9
references: 16313505
references: Sleep Med Rev. 2001 Oct;5(5):363-374
references: 12531000
references: Arthritis Rheum. 2005 Apr 15;53(2):272-8
references: 15818653
references: Psychiatry Res. 1998 Oct 19;81(1):1-8
references: 9829645
references: J Arthroplasty. 2003 Apr;18(3):371-6
references: 12728433
references: Arthritis Rheum. 1996 Nov;39(11):1852-9
references: 8912507
references: Br J Rheumatol. 1998 Jan;37(1):71-81
references: 9487254
references: Ann Rheum Dis. 1993 Mar;52(3):245
references: 8484686
references: NIH Consens State Sci Statements. 2005 Jun 13-15;22(2):1-30
references: 17308547
references: J Rheumatol. 2003 May;30(5):1070-4
references: 12734908
references: Rheumatology (Oxford). 2000 Nov;39(11):1287-9
references: 11085813
references: J Rheumatol. 1994 Jun;21(6):1113-7
references: 7932424
references: J Rheumatol. 1993 Oct;20(10):1756-9
references: 8295190
references: JAMA. 1999 Mar 17;281(11):991-9
references: 10086433
references: Health Psychol. 2006 Jan;25(1):15-9
references: 16448293
references: J Consult Clin Psychol. 2000 Jun;68(3):407-16
references: 10883557
references: J Rheumatol. 1996 Mar;23(3):529-33
references: 8832997
references: Health Psychol. 2006 Jan;25(1):3-14
references: 16448292
references: Lancet Neurol. 2005 Aug;4(8):465-75
references: 16033689
references: J Intern Med. 2002 Mar;251(3):207-16
references: 11886479
references: J Am Geriatr Soc. 2000 Oct;48(10):1241-51
references: 11037011
references: Clin Exp Rheumatol. 1987 Oct-Dec;5(4):363-5
references: 3501972
references: Sleep. 1987 Feb;10(1):45-56
references: 3563247
references: Arthritis Care Res. 1999 Aug;12(4):247-55
references: 10689989