title: Effect of intermittent aerobic exercise on sleep quality and sleep disturbances in patients with rheumatoid arthritis - design of a randomized controlled trial.
abstract: BACKGROUND
  Poor sleep is prevalent in patients with systemic inflammatory disorders, including rheumatoid arthritis, and, in addition to fatigue, pain, depression and inflammation, is associated with an increased risk of co-morbidity and all-cause mortality. Whereas non-pharmacological interventions in patients with rheumatoid arthritis have been shown to reduce pain and fatigue, no randomized controlled trials have examined the effect of non-pharmacological interventions on improvement of sleep in patients with rheumatoid arthritis. The aim of this trial was to evaluate the efficacy of an intermittent aerobic exercise intervention on sleep, assessed both objectively and subjectively in patients with rheumatoid arthritis.
  
  
  METHODS
  A randomized controlled trial including 44 patients with rheumatoid arthritis randomly assigned to an exercise training intervention or to a control group. The intervention consists of 18 session intermittent aerobic exercise training on a bicycle ergometer three times a week. Patients are evaluated according to objective changes in sleep as measured by polysomnography (primary outcome). Secondary outcomes include changes in subjective sleep quality and sleep disturbances, fatigue, pain, depressive symptoms, physical function, health-related quality of life and cardiorespiratory fitness.
  
  
  CONCLUSIONS
  This trial will provide evidence of the effect of intermittent aerobic exercise on the improvement of sleep in patients with rheumatoid arthritis, which is considered important in promotion of health and well-being. As such, the trial meets a currently unmet need for the provision of non-pharmacological treatment initiatives of poor sleep in patients with rheumatoid arthritis.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01966835.
authors.affiliation: Research Unit of Nursing and Health Science, Glostrup Hospital, Copenhagen University, Copenhagen, Denmark. katrine.bjerre.loeppenthin@regionh.dk.
authors.forename: Katrine
authors.initials: K
authors.lastname: Løppenthin
authors.forename: Bente Appel
authors.initials: BA
authors.lastname: Esbensen
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
authors.forename: Mikkel
authors.initials: M
authors.lastname: Østergaard
authors.forename: Jesper Frank
authors.initials: JF
authors.lastname: Christensen
authors.forename: Tanja
authors.initials: T
authors.lastname: Thomsen
authors.forename: Julie Schjerbech
authors.initials: JS
authors.lastname: Bech
authors.forename: Julie
authors.initials: J
authors.lastname: Midtgaard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000628:therapy*; D015444:Exercise; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D017286:Polysomnography; D016037:Single-Blind Method; D020919:Sleep Disorders, Intrinsic / Q000209:etiology / Q000628:therapy*; D055815:Young Adult