title: Sleep quality in fibromyalgia and rheumatoid arthritis: associations with pain, fatigue, depression, and disease activity.
abstract: OBJECTIVE
  The aim of this study was to compare the sleep quality in patients with rheumatoid arthritis (RA) and fibromyalgia syndrome (FMS); and to evaluate the relationship between sleep quality and pain, fatigue, depression, and disease activity in patients with RA and FMS.
  
  
  METHODS
  Forty RA, 40 FMS and 40 healthy controls were enrolled in the study. Disease activity and disease duration were reported in patients. Pain by visual analogue scale (VAS), fatigue by Multidimensional Assesment of Fatigue (MAF), depression by Beck Depression Index (BDI), and sleep quality by Pittsburgh Sleep Quality Index (PSQI) were gathered in all participants.
  
  
  RESULTS
  All participants were aged between 20 and 65 years, with a mean age of 42.97±10.75 years. There was no significant difference with respect to demographic characteristics among the three study groups. Patients reported more depression than controls, but BDI scores were similar in FMS and RA patients. VAS pain scores and MAF scores were significantly different in the three groups (p<0.001). FMS and RA patients had poor sleep quality (p<0.001). FMS patients had daytime dysfunction due to sleep disorder and had worse habitual sleep efficiency than RA patients (p<0.05). In patients, positive correlations were found between PSQI and clinic assessment variables except disease duration.
  
  
  CONCLUSIONS
  FMS and RA may have poor sleep quality when compared to subjects without rheumatologic disorders. The quality of sleep can be impaired by pain, fatigue, depression, and disease activity in such patients.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey. yaseminulus@gmail.com
authors.forename: Y
authors.initials: Y
authors.lastname: Ulus
authors.forename: Y
authors.initials: Y
authors.lastname: Akyol
authors.forename: B
authors.initials: B
authors.lastname: Tander
authors.forename: D
authors.initials: D
authors.lastname: Durmus
authors.forename: A
authors.initials: A
authors.lastname: Bilgici
authors.forename: O
authors.initials: O
authors.lastname: Kuru
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D059350:Chronic Pain / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D015897:Comorbidity; D005221:Fatigue; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D013577:Syndrome; D055815:Young Adult