title: Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life.
abstract: BACKGROUND
  The aim of this study was to evaluate sleep quality and the related variables in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Ninety-four patients diagnosed with RA and fifty two healthy controls were enrolled in the study. Disease activity was assessed through the Disease Activity Score (DAS) 28 scale. All patients were assessed using the Rheumatoid Arthritis Quality of Life and Health Assessment Questionnaire scales, together with the Beck Depression Inventory. Radiological damage was calculated with the modified Larsen method. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of the sleep disturbance.
  
  
  RESULTS
  The patients with RA had significantly higher scores in the subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance domains and the total PSQI score compared to the healthy control group. According to the results of Spearman's analysis, there was a significantly correlation between the age, disease activity, CRP, pain, fatigue, depression, functional disability, quality of life, radiological damage, menopause status, duration of morning stiffness, ESR levels and the sleep disturbance. The logistic regression analysis indicated that depression and DAS 28 scores were predictors for poor sleep quality.
  
  
  CONCLUSIONS
  The sleep quality is disturbed in patients with RA. The poor sleep quality is especially associated with the disease activity and depression.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Mustafa Akif
authors.initials: MA
authors.lastname: Sariyildiz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Batmaz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Bozkurt
authors.affiliation: Department of Psychiatry, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Bez
authors.affiliation: Department of Radiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Mehmet Guli
authors.initials: MG
authors.lastname: Cetincakmak
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Yazmalar
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Ucar
authors.affiliation: Department of Family Physician, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Tahsin
authors.initials: T
authors.lastname: Celepkolu
keywords: Depression; Disease activity; Rheumatoid arthritis; Sleep quality