Evaluation of sleep quality in patients with ankylosing spondylitis and efficacy of anti‐TNF‐α therapy on sleep problems: A polisomnographic study
Abstract
Introduction: This study was conducted to investigate the relationship between sleep quality (SQ) and disease activity (DA) in patients with ankylosing spondylitis (AS) and to evaluate the response to anti‐tumor necrosis factor α (anti‐TNF‐α) therapy on sleep disorders. Materials and Methods: A total of 34 patients who met the modified New York classification criteria for AS were included in this prospective study. Patients were divided into two groups as follows: Group I (n = 15) with high DA and receiving anti‐TNF‐α therapy, and Group II (n = 19) in remission. DA was assessed by the Bath AS Disease Activity Index. Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were used to determine disorders and patterns of sleep, respectively, in both groups at baseline as well as at the third month of anti‐TNF‐α therapy in Group I. Results: Baseline evaluation revealed impaired SQ in 57.9% of all patients. PSG demonstrated obstructive sleep apnea syndrome, snoring and periodic leg movements in 73.7%, 74.4% and 26.3% of patients, respectively. Prior to anti‐TNF‐α therapy, PSQI and snoring score were significantly higher in Group I (P = 0.0001, P = 0.012, respectively). Although there was a significant reduction in PSQI scores in Group I (P = 0.005) at the third month of anti‐TNF‐α therapy, no change was observed in PSG parameters (P > 0.05). Conclusion: Sleep disorders increase in AS, particularly in patients with high DA. Anti‐TNF‐α therapy has improved SQ without any improvement in PSG. Therefore, it may be concluded that PSG parameters might be more associated with disease pathogenesis rather than DA in patients with AS.
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Anti-TNF therapy in RA patients with high disease activity improves self-reported sleep quality without affecting PSG-derived sleep parameters.
“In contrast, treatment with anti-TNF therapy in RA patients with high disease activity resulted in an improvement of self-reported sleep quality, without affecting PSG-derived sleep parameters (283).”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [283]
Treatment of RA patients with IL-6 or TNF blockers improved sleep.
“As described in section IID2, treatment of RA patients with IL-6 or TNF blockers improved sleep (196, 283, 535).”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [283]
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The Sleep-Immune Crosstalk in Health and Disease
Besedovsky, L., Lange, T., & Haack, M. (2019) · Physiological Reviews · doi:10.1152/physrev.00010.2018 · Cited by 1,479 · see citing works
“Comparable effects of anti-TNF therapy on sleep were found in patients with IBD and ankylosing spondylitis (282, 527).”
Background
- Authors
- Karatas, G., Bal, A., Yuceege, M., Firat, H., Gurcay, E., Ardic, S., & Cakci, F. A.
- Affiliations
- Department of Physical Medicine and Rehabilitation Karabuk University Faculty of Medicine Karabuk Turkey
- Department of Physical Medicine and Rehabilitation Diskapi Education and Research Hospital Ankara Turkey
- Department of Respiratory Medicine and Sleep Clinic Diskapi Education and Research Hospital Ankara Turkey
- Venue
- International Journal of Rheumatic Diseases
- Publisher
- Wiley
- Published
- 2017-05-29
- Volume
- 21
- Issue
- 6
- Pages
- 1263-1269
- ISSN
- 1756-1841 (ISSN-L)
- 1756-185X
- OpenAlex
- W2618399580
- Cited by
- 29
- References
- 38
- Citations by year
- 2026: 6 · 2025: 5 · 2023: 6 · 2022: 1 · 2021: 4 · 2019: 6 · 2018: 1
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Rheumatic Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Spondyloarthritis Studies and Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- ankylosing spondylitis, sleep quality, sleep disorders, anti-TNF therapy, disease activity, obstructive sleep apnea, snoring, periodic limb movements, polysomnography, Pittsburgh Sleep Quality Index, Bath AS Disease Activity Index
- MeSH terms
- Adult, Biological Products, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Surveys and Questionnaires, Remission Induction, Severity of Illness Index, Sleep, Sleep Wake Disorders, Spondylitis, Ankylosing, Time Factors, Tumor Necrosis Factor-alpha, Treatment Outcome, Polysomnography, Antirheumatic Agents
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