SAT0087 ESTIMATED SLEEP DURATION AND CARDIOVASCULAR RISK IN RHEUMATOID ARTHRITIS: A CASE CONTROL STUDY
Authors: D. Á. Galarza-Delgado, J. R. Azpiri-López, I. J. Colunga-Pedraza, M. A. Reyes Soto, A. Pérez Villar, I. C. Zárate Salinas, P. F. Frausto Lerma
Journal: Annals of the Rheumatic Diseases (2020)

Background: Sleep is essential to human health and it is increasingly regarded as an important lifestyle behavior. The reduction in sleep duration have been linked to an increased risk of cardiovascular disease (CVD) and death in general population (1). Patients with rheumatoid arthritis (RA) have a higher risk of CVD and as in other pain conditions, commonly report poor sleep quality as well as feeling unrested and fatigued after sleep (2). This can be attributed to a lack of awareness of sleep hygiene. Objectives: To determine the prevalence of self-reported estimated duration of total daily sleep, daytime naps and quality of sleep of patients with RA and without rheumatic diseases and its association with cardiovascular risk factors. Methods: Observational, cross-sectional study. RA patients aged 40 to 75 years that fulfilled 2010 ACR/EULAR criteria and controls (without RA) were included. Sleep duration and quality, daytime naps and awareness of sleep hygiene were assessed with self-administered questionnaire. Descriptive analysis was done with frequencies (%), mean (SD), median (q25-q75). Comparisons with Chi-square, Mann-Whitney U test and Wilcoxon. Binary regression analysis was used to test association between estimated sleep duration (&lt;6h), cardiovascular risk factors and RA diagnosis. Results: A total of 217 subjects were included. RA patients 93 (91.2%) vs 55 (47.8%) controls were female. Mean (SD) age was RA 56.68 (± 10.73) vs 57.27 (± 10.06) controls. Estimated sleep duration (&lt;6h) was higher in RA with 20.6% vs 8.7% in controls (p=0.012). There was no significative difference of the awareness of sleep hygiene 7.8% and 12.2% in the case and control group, respectively (p= 0.291). Obstructive sleep apnea was higher in controls 9.6% (p=0.047). The rest of the characteristics are displayed in table 1. Binary regression showed that having RA makes you 60% more likely to sleep less than six hours OR 0.40, 95% CI (0.17-0.92) (p=0.031). Patients with estimated sleep duration (&lt;6h) had higher prevalence of Hypertension 51.6% vs 48.4% (p=0.022) Table 1. Cardiovascular risk factors and sleep characteristics RA (n=102) Controls (n=115) p Obesity, n (%) 23 (25.3) 31 (31.3) NS Current smoker, n (%) 12 (11.8) 21 (18.3) NS Diabetes Mellitus, n (%) 15 (14.7) 13 (11.3) NS Dyslipidemia, n (%) 32 (31.5) 30 (26) NS Hypertension, n (%) 40 (39.2) 33 (28.7) NS Cardiovascular event, n (%) 5 (4.9) 3 (2.5) NS Obstructive Apnea Sleep, n (%) 3 (2.9) 11 (9.6) 0.047 Estimated sleep time (&lt;6h), n (%) 21 (20.6) 10 (8.7) 0.012 Participants taking naps, n (%) 47 (46.1) 50 (43.5) NS Number of daytime naps at week, median (q25-q75) 0 (0-7) 1 (0-7) 0.007 Duration of daytime naps (min), median (q25-q75) 0 (0-30) 15 (0-40) NS Good Sleep quality, n (%) 67 (65.7) 69 (60) NS Conclusion: Patients with RA had a higher frequency of less estimated sleep time, this is associated with hypertension, risk of deaths and major cardiovascular events. Additionally, to inflammation and coexistence of CVD risk in RA. There was an absence of awareness of most of the individuals of sleep hygiene. Therefore, in clinical practice, assessment and education of sleep patterns may be of value in identifying higher risk individuals. An integrated care approach may contribute to the awareness of healthcare professionals to develop appropriate interventions. References: [1] Wang, C., et al (2019). Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries. Eur Heart J, 40 (20), 1620-1629. [2] Grabovac, I., et al (2018). Sleep Quality in Patients with Rheumatoid Arthritis and Associations with Pain, Disability, Disease Duration, and Activity. J Clin Med, 7 (10). Disclosure of Interests: None declared