Abstract
Regular physical activity (PA) is important for people with rheumatoid arthritis (RA). Poor sleep is a common complaint among people with RA, which may have an influence on their PA levels. There is a lack of objective information regarding total sleep time (TST) and PA duration in this population. A cross-sectional study design was used. SenseWear Pro3 Armband(R)TM is used to measure TST and total PA duration. Four valid days, with 95% wear time necessary for inclusion in final results. Disease activity and function were measured using the DAS-28, HAQ and VAS. Data analysis carried out using SPSS v22. Seventy-five (75) participants completed monitoring period, with 51 (68%) meeting modified PA duration guidelines. Data with 95% wear time over a minimum of 4 days were available for 32 recorded participants, with a mean TST of 5.7 (SD_1.11) hours per night and a median 1.25 (IQR_1.88) hours of daily PA. TST had a positive significant relationship with PA (p = 0.018); PA demonstrated a negative significant relationship with functional limitations (p = 0.009) and correlated with lower CRP levels; CRP levels had in turn a significant relationship to global health (p = 0.034). Total sleep time was low for people with RA. People with RA who are more physically active have longer TST. These findings provide an objective profile of TST and PA duration in people with RA and suggest a relationship between increased PA duration and longer TST. Further research is needed to confirm these novel findings.
Similar content being viewed by others
Change history
05 September 2018
The original article can be found online.
References
Firestein GS (2005) Immunologic mechanisms in the pathogenesis of rheumatoid arthritis. JCR J Clin Rheumatol 11:S39–S44
Rongen-van Dartel SAA, Repping-Wuts H, Flendrie M, Bleijenberg G, Metsios GS, van den Hout WB, van den Ende CHM, Neuberger G, Reid A, van Riel P (2015) Effect of aerobic exercise training on fatigue in rheumatoid arthritis: a meta-analysis. Arthritis Care Res 67:1054–1062
Løppenthin K, Esbensen BA, Østergaard M, Jennum P, Tolver A, Aadahl M, Thomsen T, Midtgaard J (2015) Physical activity and the association with fatigue and sleep in Danish patients with rheumatoid arthritis. Rheumatol Int 35:1655–1664
McKenna SG, Kennedy N (2016) OP0294-HPR sleep quality, sleep disturbances and physical activity: a national survey of irish people who have inflammatory arthritis. Ann Rheum Dis 75:169-
Eurenius E, Brodin N, Lindblad S, Opava CH, Group PS (2007) Predicting physical activity and general health perception among patients with rheumatoid arthritis. J Rheumatol 34:10–15
Tierney M, Fraser A, Kennedy N (2012) Physical activity in rheumatoid arthritis: a systematic review. J Phys Act Health 9(7):1036–1048
Flemons WW, Buysse D, Redline S, Oack A, Strohl K, Wheatley J, Young T, Douglas N, Levy P, McNicolas W (1999) Sleep-related breathing disorders in adults. Sleep 22:667–689
Lucassen PJ, Meerlo P, Naylor AS, Van Dam AM, Dayer AG, Fuchs E, Oomen CA, Czeh B (2010) Regulation of adult neurogenesis by stress, sleep disruption, exercise and inflammation: implications for depression and antidepressant action. Eur Neuropsychopharmacol 20:1–17
Hurkmans E, van der Giesen FJ, Vliet Vlieland TP, Schoones J, Van den Ende EC (2009) Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis. Cochrane Database Syst Rev 9:CD006853
Knittle KP, De Gucht V, Hurkmans EJ, Vlieland TPM, Peeters AJ, Ronday HK, Maes S (2011) Effect of self-efficacy and physical activity goal achievement on arthritis pain and quality of life in patients with rheumatoid arthritis. Arthritis Care Res 63:1613–1619
Nicassio PM, Ormseth SR, Kay M, Custodio M, Irwin MR, Olmstead R, Weisman MH (2012) The contribution of pain and depression to self-reported sleep disturbance in patients with rheumatoid arthritis. Pain 153:107–112
Cramp F, Hewlett S, Almeida C, Kirwan JR, Choy EH, Chalder T et al (2013) Non-pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev 8:CD008322
Yang P-Y, Ho K-H, Chen H-C, Chien M-Y (2012) Exercise training improves sleep quality in middle-aged and older adults with sleep problems: a systematic review. J Physiother 58:157–163
Courneya KS, Segal RJ, Mackey JR, Gelmon K, Friedenreich CM, Yasui Y, Reid RD, Jespersen D, Cook D, Proulx C (2014) Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial. Breast Cancer Res Treat 144:361–369
Bansil P, Kuklina EV, Merritt RK, Yoon PW (2011) Associations between sleep disorders, sleep duration, quality of sleep, and hypertension: results from the National Health and Nutrition Examination Survey, 2005 to 2008. J Clin Hypertens 13:739–743
Ogdie A, Yu Y, Haynes K, Love TJ, Maliha S, Jiang Y, Troxel AB, Hennessy S, Kimmel SE, Margolis DJ (2015) Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis 74:326–332
Ancoli-Israel S, Cole R, Alessi C, Chambers M, Moorcroft W, Pollak C (2003) The role of actigraphy in the study of sleep and circadian rhythms. Am Acad Sleep Med Rev Pap Sleep 26:342–392
Sunseri M, Liden CB, Farringdon J, Pelletier R, Safier S, Stivoric J, Teller A, SureshVishnubhatla M (2009) The SenseWear? Armband as a sleep detection device. BodyMedia internal white paper Healthy MDD Sleep duration min Sleep Quality Score, pp 1–9
Alsaadi SM, McAuley JH, Hush JM, Bartlett DJ, McKeough ZM et al (2014) Assessing sleep disturbance in low back pain: the validity of portable instruments. PLoS ONE 9(4):e95824. https://doi.org/10.1371/journal.pone.0095824
Berntsen S, Hageberg R, Aandstad A, Mowinckel P, Anderssen SA, Carlsen KH, Andersen LB (2010) Validity of physical activity monitors in adults participating in free living activities. Br J Sports Med 44(9):657–664
Van Remoortel H, Giavedoni S, Raste Y, Burtin C, Louvaris Z, Gimeno-Santos E, Langer D, Glendenning A, Hopkinson NS, Vogiatzis I (2012) Validity of activity monitors in health and chronic disease: a systematic review. Int J Behav Nutr Phys Act 9:84
Tierney M, Fraser A, Purtill H, Kennedy N (2013) Study to determine the criterion validity of the SenseWear Armband as a measure of physical activity in people with rheumatoid arthritis. Arthritis Care Res 65:888–895
Mackey DC, Manini TM, Schoeller DA, Koster A, Glynn NW, Goodpaster BH, Satterfield S, Newman AB, Harris TB, Cummings SR (2011) Validation of an armband to measure daily energy expenditure in older adults. J Gerontol Ser A Biomed Sci Med Sci 66:1108–1113
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, Strobe I (2014) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg 12:1495–1499
Fries JF, Ramey DR (1997) "Arthritis specific” global health analog scales assess” generic” health related quality-of-life in patients with rheumatoid arthritis. J Rheumatol 24:1697–1702
Wolfe F, Kleinheksel SM, Cathey MA, Hawley DJ, Spitz PW, Fries JF (1988) The clinical value of the Stanford Health Assessment Questionnaire Functional Disability Index in patients with rheumatoid arthritis. J Rheumatol 15:1480–1488
Liden CB, Wolowicz M, Stivoric J, Teller A, Kasabach C, Vishnubhatla S, Pelletier R, Farringdon J, Boehmke S (2002) Characterization and implications of the sensors incorporated into the SenseWear armband for energy expenditure and activity detection. Bodymedia Inc. White Papers: 1, 7
Corder K, Ekelund U, Steele RM, Wareham NJ, Brage S (2008) Assessment of physical activity in youth. J Appl Physiol 105:977–987
Almeida GJM, Wasko MCM, Jeong K, Moore CG, Piva SR (2011) Physical activity measured by the SenseWear Armband in women with rheumatoid arthritis. Phys Ther 91:1367–1376
Ott RL, Longnecker MT (2015) An introduction to statistical methods and data analysis. Nelson Education, Toronto
Tabachnick BG, Fidell LS (2007) Using multivariate statistics. Allyn & Bacon/Pearson Education, Boston
McKenna S, Donnelly A, Fraser A, Kennedy N (2017) Sleep and physical activity: a survey of people with inflammatory arthritis and their engagement by health professionals in rheumatology in Ireland. Disabil Rehabil. 2017:1–7
Katz P, Margaretten M, Trupin L, Schmajuk G, Yazdany J, Yelin E (2016) Role of sleep disturbance, depression, obesity, and physical inactivity in fatigue in rheumatoid arthritis. Arthritis Care Res 68:81–90
Løppenthin K, Esbensen BA, Jennum P, Østergaard M, Tolver A, Thomsen T, Midtgaard J (2015) Sleep quality and correlates of poor sleep in patients with rheumatoid arthritis. Clin Rheumatol 34:2029–2039
Fenton SAM, van Zanten JJCSV., Kitas GD, Duda JL, Rouse PC, Yu C-a, Metsios GS (2017) Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity. BMC Musculoskelet Disord 18:131
Vitiello MV, Larsen LH, Moe KE (2004) Age-related sleep change: gender and estrogen effects on the subjective–objective sleep quality relationships of healthy, noncomplaining older men and women. J Psychosom Res 56:503–510
Campbell SS, Gillin JC, Kripke DF, Erikson P, Clopton P (1989) Gender differences in the circadian temperature rhythms of healthy elderly subjects: relationships to sleep quality. Sleep 12:529–536
Zhang B, Wing Y-K (2006) Sex differences in insomnia: a meta-analysis. Sleep 29:85–93
Brosseau L, Wells GA, Tugwell P, Egan M, Dubouloz C-J, Casimiro L, Robinson VA, Pelland L, McGowan J, Bell M (2004) Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercises in the management of rheumatoid arthritis in adults. Phys Ther 84:934–972
McKenna S, Kelly G, Kennedy N (2014) FRI0585-HPR A survey of Irish physiotherapists’ current practice in promoting physical activity in rheumatoid arthritis. Ann Rheum Dis 73:1206–1207
McKenna SG, Brodin N, Nordgren B, Esbensen BA, Swinnen T, Hammer NM, Willemijns S, Kennedy N (2016) THU0650-HPR physical activity and aerobic capacity assessment-a survey among health professionals in Sweden, Ireland and Denmark. Ann Rheum Dis 75:1274
Larkin L, Kennedy N, Gallagher S (2015) Promoting physical activity in rheumatoid arthritis: a narrative review of behaviour change theories. Disabil Rehabil 37:2359–2366
Sokka T, Häkkinen A, Kautiainen H, Maillefert JF, Toloza S, Calvo-Alen J, Oding R, Liveborn M, Huisman M, Alten R (2008) Physical inactivity in patients with rheumatoid arthritis: data from twenty-one countries in a cross-sectional, international study. Arthritis Care Res 59:42–50
Thomsen T, Beyer N, Aadahl M, Hetland ML, Løppenthin K, Midtgaard J, Esbensen BA (2015) Sedentary behaviour in patients with rheumatoid arthritis: a qualitative study. Int J Qual Stud Health Well Being 10(1):28578
McKenna S, Donnelly A, Fraser A, Comber L, Kennedy N (2017) Does exercise impact on sleep for people who have rheumatoid arthritis? A systematic review. Rheumatol Int 2017:1–12
McBeth J, Prescott G, Scotland G, Lovell K, Keeley P, Hannaford P, McNamee P, Symmons DPM, Woby S, Gkazinou C (2012) Cognitive behavior therapy, exercise, or both for treating chronic widespread pain. Arch Intern Med 172:48–57
Beasley M, Prescott GJ, Scotland G, McBeth J, Lovell K, Keeley P, Hannaford PC, Symmons DPM, MacDonald RIR, Woby S (2015) Patient-reported improvements in health are maintained 2 years after completing a short course of cognitive behaviour therapy, exercise or both treatments for chronic widespread pain: long-term results from the MUSICIAN randomised controlled trial. RMD Open 1:e000026
Youngstedt SD (2005) Effects of exercise on sleep. Clin Sports Med 24:355–365
Hekler EB, Buman MP, Haskell WL, Conway TL, Cain KL, Sallis JF, Saelens BE, Frank LD, Kerr J, King AC (2012) Reliability and validity of CHAMPS self-reported sedentary-to-vigorous intensity physical activity in older adults. J Phys Act Health 9:225–236
Funding
Sean McKenna (SMcK) reports a competitive postgraduate scholarship awarded by the Irish Research Council (IRC) (GOIPG/2016/58).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
SMcK & MT report separate Irish Research Council Grants and all other authors declare no conflicts of interest.
Rights and permissions
About this article
Cite this article
McKenna, S., Tierney, M., O’Neill, A. et al. Sleep and physical activity: a cross-sectional objective profile of people with rheumatoid arthritis. Rheumatol Int 38, 845–853 (2018). https://doi.org/10.1007/s00296-018-4009-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-018-4009-1