AB1460-HPR Psychological variables predictor of sleep disorders in patients with ankilosing spondilylitis and psoriastic artrtits. multicenter study
Authors: L Cano Garcia, N. Mena-Vázquez, M.D. Hernández-Sánchez, R. SEGURA-RUIZ, C. Domínguez-Quesada, S. Manrique-Arija, I. Ureña-Garnica, F.G. Jiménez-Núñez, E. Vilchez-Ocaña, A. Fernández-Nebro
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> To study the variables associated with the severity of insomnia and hypersomnia according to the Oviedo sleep questionnaire (COS) in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA). <h3>Methods</h3> Design. Transversal descriptive study. PATIENTS: Patients with follow-up AS or PSA were selected by consecutive sampling in rheumatology units of 4 Spanish cities. Selection criteria: age ≥16 years old) with AE (New York criteria) or PSA (CASPAR criteria) able to understand and willing to carry out the questionnaires. Protocol: they were explained and the patients were given to meet the selection criteria and the informed consent signed a battery of questionnaires; his doctor performed the evaluation of disease activity and recorded comorbidities and current medication. Main outcomes: the 3 dimensions of COS:<sup>1</sup> Subjective satisfaction with sleep,<sup>2</sup> Insomnia and<sup>3</sup> Hyperinsomnia. Other variables: current medication for AE or PsA, comorbidities, use of sleeping drugs and/or CPAP according to the COS questionnaire, disease activity: axial AS (BASDAI) and PSA (DAS28), quality of life related to health (HRQOL) through SF-36, pain perception (Brief Pain Inventory BPI questionnaire), AE (BASDAI) and PSA (DAS28) and fatigue through FACIT, emotional intelligence through TMMS, resilience with the resilience questionnaire, anxiety screening and depression through HADs. Statistical analysis: Descriptive analysis of the main variables. Bivariate using T-Student, Mann Whitney U and χ2 followed by binary logistic regression (RLB) (Vd: Insomnia: value greater than 22 of the insomnia scale). <h3>Results</h3> 302 patients participated: 152 patients with AE and 149 patients with PA (47.8% women, 48.97±10.26 years) with an average of 8.35±6.8 years of disease. They used 47.8% biological therapy. The most frequent comorbidities were: disc disease 143 (47.5%), visual impairment 60 (19.9%), anxiety 49 (16.3%), obesity 47 (15.6%) and depression 45 (15%).In the bivariate analysis it was observed that patients with AE suffered more insomnia than patients with PSA (57% vs 43%, p=0.029), they took more drugs to sleep (30.3% vs 22.9%, p=0.001) and suffered a higher activity of the disease measured by BASDAI (mean [SD] 4.7 [1.8] vs 3.8 [1.9], p=0.005). In insomnia in PsA, it was not associated with the degree of activity measured by DAS28 but it was associated with depression. In the binary logistic regression analysis (RLB), insomnia was associated with BASDAI and depression. Therefore, patients with greater BASDAI and depression have almost twice the risk of presenting insomnia in patients with spondyloarthropathies. There are no associations of insomnia with the resilience and emotional intelligence with results above the cut, that is, patients with good resilience and emotional intelligence. <h3>Conclusions</h3> There is an association between insomnia, disease activity and depression in the group of AE, in the case of PSA there is a relationship with depression. Insomnia is a problem related to depression, so education in sleep hygiene in nursing consultation could be of help for insomnia. <h3>Disclosure of Interest</h3> None declared