Table 4 Studies investigating relationship between prognostic factors and sleep outcomes
Author (YR) | Sleep domains examined | Measurement of sleep outcome | Factors examined | Measurement of factor | Results |
|---|---|---|---|---|---|
Sleep wake patterns and behaviours | |||||
Zamir (1998) [7] | Total number of index arousals, or, stage shifts or leg movements (Sleep fragmentation) | Polysomnography | Number of active joints, Duration of stiffness, ESR | Rheumatologic examination | Multiple linear regression revealed no association between number of active joints, duration of stiffness, or ESR, with the total number or index of arousals or awakening, stage shifts, or leg movements (NS) |
Palermo (2005) [26] | Sleep wake problems | Sleep-Wake Behavior Problems Scale | Functioning | FDI | In multivariate regression functioning was predictive of sleep wake problems (β = 0.665, p = 0.054) |
Pain severity | Faces Pain Scale | In multivariate regression pain severity was not significantly predictive of sleep wake problems (β = 0.593, p = 0.126) | |||
Pain frequency | 6-point scale ranging from less than once a month to daily | In multivariate regression, pain frequency was not significantly predictive of sleep wake problems (β = -0.162, p = 0.665) | |||
Passarelli (2006) [27] | Alpha/delta waves, periodic leg movement, isolated leg movements | Polysomnography | Morning stiffness | Rheumatologic examination | Morning stiffness was significantly correlated to periodic leg movement (rs = 0.75, p = 0.00009) and isolated leg movements (rs = 0.78, p = 0.00003) |
Pain score | Self-assessment of pain on a categorical 5-point face scale ranging from “no hurt” to “hurts worst” | Pain score was significantly correlated with alpha/delta waves (rs = 0.74, p = 0.0001) | |||
Ward (2008) [3] | Wake and sleep stages, apnea/ hypopnea index (AHI), periodic leg movements | Polysomnography | Sleep quality | SSR | In the multivariate regression model testing predictors of the disturbed sleep (arousals), age and medications, anxiety, and evening pain explained 18% of variance, but neither anxiety or pain had a significant effect (both p > .05) |
Anxiety | RCMAS | Anxiety did not predict sleep disturbances (β = -0.30, p = 0.19) | |||
Medications | Parents completed a daily diary of medications their child received | Medications did predict sleep disturbance (β = 0.11, p < .04) | |||
Evening pain | Oucher Faces Rating Pain Scale | Evening pain did not predict sleep disturbances (β = 0.23, p = 0.19) | |||
Ward (2010) [28] | Apnea/ hypopnea index (AHI), awakenings, arousal | Polysomnography | Reaction time | CANTAB | Reaction time was inversely correlated with awakenings and arousals (r = -0.32, p < 0.03) |
Inadequate sleep quality | |||||
Bloom (2002) [25] | Sleep habits | CSHQ | Function | JAFAR | Functional disability was not significantly correlated with sleep habits (rs = 0.253, p = 0.222) |
Limited joint count | NR | Limited joint count was not significantly correlated with sleep habits (rs = -0.184, p = 0.380) | |||
Active joint count | NR | Active joint count was not significantly correlated with sleep habits (rs = -0.100, p = 0.633) | |||
Parent global rating | Varni Pediatric Pain Questionnaire | Parental global rating was not significantly correlated with sleep habits (rs = 0.262 p = 0.207) | |||
Physician global rating | Overall disease activity on a scale of 0-4 (0 = no disease activity, 4 = very severe disease) | Physician global rating was not significantly correlated with sleep habits (rs = 0.258, p = 0.212) | |||
ESR | Clinical pathology laboratory by standard methods | ESR was not significantly correlated with sleep habits (rs = 0.102, p = 0.628) | |||
SSR | Average pain | VAS | Average pain score was significantly correlated with sleep habits (rs = 0.56, p = 0.005) | ||
Long (2008) [1] | Sleep disturbance | CSHQ | Functioning | FDI - child and parent report | Child report of functional disability was not significantly correlated with sleep disturbance (r = 0.190, NS) |
Parental report of functional disability was significantly correlated with sleep disturbance (r = 0.646, p < 0.01) | |||||
Physical and psychosocial HRQOL | Child’s Health Questionnaire | Physical and psychosocial HRQOL was inversely correlated with sleep disturbance (r = -0.813, p < 0.01) | |||
Disease severity (global rating), daily pain | VAS (100-mm) | Disease severity was significantly correlated with sleep quality (β = 0.05, p > .05) | |||
Butbul Aviel (2011) [29] | Sleep disturbance | CSHQ | Number of tender and swollen joints | Number of swollen and painful joints by parents’ and patients’ self-report joint count—using a pictorial (mannequin) format. | Self reported sleep habits was slightly correlated with number of tender joints (r = 0.241) and swollen joints (r = 0.163) |
Global pain, worst pain | VAS | Self reported sleep habits was significantly correlated with global pain (r = 0.32, p = 0.0003) | |||
Number of painful areas, present pain | SSR | Self reported sleep habits was significantly correlated with (r = 0.32, p = 0.0003) | |||
Fatigue | PedsQL fatigue | Self reported sleep habits were inversely correlated with self reported fatigue (r = -0.45, p < 0.0001) | |||
Ward (2011) [30] | Sleep disturbance | CSHQ | Reaction time | CANTAB | Reaction time on CANTAB was significantly correlated with sleep disturbance (β = 0.18, p = 0.22) |
Bromberg (2012) [31] | Sleep quality | VAS (100-mm, ranging from did not sleep well to slept very well) | Age | Age was inversely correlated with sleep quality (β = -0.39, p > .05) | |