SP0172 What effect does exercise have on sleep in rmd?
Authors: S.G. Mckenna
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Circadian rhythms are physical, mental and behavioural changes that follow a daily cycle. Sleep in an essential aspect in maintaining the body's circadian rhythm and maintain health-related quality of life (HQoL) therfore, sleep disturbances can have a detrimental impact on same. The Outcome Measures in Rheumatology (OMERACT) has identified sleep as one of the key outcomes important to RMD patients.<sup><sup>1</sup></sup> Patients with various immune-mediated inflammatory diseases, including rheumatoid arthritis, have reported disturbed sleep and reduced sleep duration, further adding to their disease burden.<sup><sup>2, 3</sup></sup> It has been well established that being physically active and taking regular exercise are important for those who have been diagnosed with RMD's.<sup><sup>4</sup></sup> Exercise has been identified as an important part of the nonpharmacological management of poor sleep duration and in improving sleep quality however, in a 2013 Cochrane review that examined exercise and fatigue in RA, it was noted by the authors that sleep quality was yet to be examined in this population.<sup><sup>6</sup></sup> Moreover, it is known that in general exercise improves mood state, which can also be an additional factor in improving sleep duration and sleep quality.<sup><sup>5</sup></sup> Exercise offers a potentially attractive alternative or adjuvant treatment for those people with RMD who have sleep issues. The position stand from the American College of Sports Medicine (ACSM) regarding exercise for those with chronic conditions is categorised by cardio-respiratory exercise, resistance exercise, flexibility exercise and neuro-motor exercise.<sup><sup>7</sup></sup> This presentation will consider the evidence regarding the effect exercise has on sleep in general and how the examination of a participants exercise habits prior to any study might be important, as it may have an impact on its effectiveness. A key message from the talk will be the presentation of evidence of exercise programmes in people with RMD, according to the Frequency, Intensity, Time and Type (FITT) principle will be presented.<sup><sup>8</sup></sup> <h3>References</h3> [1] Kirwan JR, Boonen A, Harrison MJ, Hewlett SE, Wells GA, Singh JA, Furst DE, Dworkin RH. OMERACT 10 Patient Perspective Virtual Campus: Valuing health; measuring outcomes in rheumatoid arthritis fatigue, RA sleep, arthroplasty, and systemic sclerosis; and clinical significance of changes in health. The Journal of Rheumatology2011;38:1728–34. [2] Graff LA, Walker JR, Russell AS, Bissonnette R, Bernstein CN. Fatigue and quality of sleep in patients with immune-mediated inflammatory disease. The Journal of Rheumatology Supplement2011;88:36–42. [3] McKenna S, Donnelly A, Fraser A, Kennedy N. Sleep and physical activity: a survey of people with inflammatory arthritis and their engagement by health professionals in rheumatology in Ireland. Disability and Rehabilitation2017:1–7. [4] Hurkmans E, van der Giesen FJ, Vliet Vlieland TPM, Schoones J, Van den Ende ECHM. Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis. <i>The Cochrane Library</i>2009. [5] Nicassio PM, Ormseth SR, Kay M, Custodio M, Irwin MR, Olmstead R, Weisman MH. The contribution of pain and depression to self-reported sleep disturbance in patients with rheumatoid arthritis. Pain2012;153:107–12. [6] Cramp F, Hewlett S, Almeida C, Kirwan JR, Choy EHS, Chalder T, Pollock J, Christensen R. Non-pharmacological interventions for fatigue in rheumatoid arthritis. <i>The Cochrane Library</i>2013. [7] Moore G, Durstine JL, Painter P, American College of Sports M. ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities, 4E. <i>Human Kinetics</i>2016. [8] McKenna S, Donnelly A, Fraser A, Comber L, Kennedy N. Does exercise impact on sleep for people who have rheumatoid arthritis? A systematic review. Rheumatology International2017;37:963–74. <h3>Disclosure of Interest</h3> None declared