Sleep Loss Exacerbates Fatigue, Depression, and Pain in Rheumatoid Arthritis
Open accessAbstract
STUDY OBJECTIVES: Disturbances of sleep are hypothesized to contribute to pain. However, experimental data are limited to healthy pain-free individuals. This study evaluated the effect of sleep loss during part of the night on daytime mood symptoms and pain perceptions in patients with rheumatoid arthritis in comparison with control subjects. DESIGN: A between-groups laboratory study with assessment of mood symptoms and pain perception before and after partial night sleep deprivation (PSD; awake 23:00 hr to 03:00 hr). SETTING: General clinical research center. PARTICIPANTS: Patients with rheumatoid arthritis (n = 27) and volunteer comparison control subjects (n = 27). MEASUREMENTS: Subjective reports of sleep, mood symptoms and pain, polysomnographic assessment of sleep continuity, and subjective and objective assessment of rheumatoid arthritis-specific joint pain. RESULTS: PSD induced differential increases in self-reported fatigue (P < 0.09), depression (P < 0.04), anxiety (P < 0.04), and pain (P < 0.01) in patients with rheumatoid arthritis compared with responses in control subjects, in whom differential increases of self-reported pain were independent of changes in mood symptoms, subjective sleep quality, and objective measures of sleep fragmentation. In the patients with rheumatoid arthritis, PSD also induced increases in disease-specific activity as indexed by self-reported pain severity (P < 0.01) and number of painful joints (P < 0.02) as well as clinician-rated joint counts (P < 0.03). CONCLUSION: This study provides the first evidence of an exaggerated increase in symptoms of mood and pain in patients with rheumatoid arthritis after sleep loss, along with an activation of rheumatoid arthritis-related joint pain. Given the reciprocal relationship between sleep disturbances and pain, clinical management of pain in patients with rheumatoid arthritis should include an increased focus on the prevention and treatment of sleep disturbance in this clinical population.
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Experimental sleep disturbance produces a greater increase in depressive symptoms in people with an inflammatory disorder.
“we have found that experimental sleep disturbance induces greater increase in depressive symptoms in persons with an inflammatory disorder (Irwin et al, 2012)”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Irwin et al, 2012
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- Authors
- Irwin, M. R., Olmstead, R., Carrillo, C., Sadeghi, N., FitzGerald, J. D., Ranganath, V. K., & Nicassio, P. M.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-04
- Volume
- 35
- Issue
- 4
- Pages
- 537-543
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC3296796
- OpenAlex
- W2033881726
- Cited by
- 279
- References
- 44
- Citations by year
- 2026: 19 · 2025: 16 · 2024: 14 · 2023: 20 · 2022: 13 · 2021: 27 · 2020: 24 · 2019: 26 · 2018: 17 · 2017: 18 · 2016: 19 · 2015: 30 · 2014: 19 · 2013: 12 · 2012: 5
- FWCI
- 28.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (UL1TR000124)
- National Institute on Aging (R01AG026364, R01AG034588, R01-AG18367, R01AG018367, P30AG028748)
- National Heart, Lung, and Blood Institute (R01HL079955)
- National Institute of Mental Health (T32-MH-18399, T32MH018399)
- National Cancer Institute (R01 CA10014152)
- National Center for Research Resources ((M01 RR00865), M01RR000865)
- NIH Clinical Center
- National Center for Advancing Translational Sciences
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Keywords
- rheumatoid arthritis, sleep deprivation, fatigue, depression, anxiety, pain perception, joint pain, mood symptoms, sleep fragmentation
- MeSH terms
- Affect, Aged, Anxiety Disorders, Arthritis, Rheumatoid, Depressive Disorder, Fatigue, Female, Humans, Male, Middle Aged, Pain, Sleep Deprivation, Cohort Studies, Self Report
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