Sleep disturbance, whether caused by insomnia or insufficient sleep, can lead to fatigue that interferes with usual daily activities for osteoarthritis patients. Sleep disturbance is not always given enough attention -- it's merely considered a consequence of osteoarthritis pain. Researchers, though, are beginning to view it as a significant problem that should be addressed as part of routine care for osteoarthritis.
The Johnston County Osteoarthritis Project
In a study, known as the Johnston County Osteoarthritis Project, 2,682 study participants (28% of whom had hip osteoarthritis or knee osteoarthritis) were assessed for insomnia or insufficient sleep. Insomnia was defined as trouble falling asleep, trouble staying asleep, or waking early. Insufficient sleep was considered daytime sleepiness, not getting enough sleep, or not feeling well-rested.
Hip or knee osteoarthritis was found to be associated with increased sleep problems -- either insomnia or insufficient sleep. Among the study participants who had sleep problems, those with osteoarthritis reported more days affected by insomnia or insufficient sleep than those without osteoarthritis. The connection between osteoarthritis and sleep disturbance was found to be independent of other factors that affect sleep including depression or other health issues.
Better Pain Control Means Better Sleep
It is logical to assume that for osteoarthritis patients - better pain control correlates with better quality of sleep. While there are several tips for better sleep, pain relief is essential. One study, reported in the April 2003 Journal of Arthroplasty, assessed sleep disturbance in osteoarthritis patients before and after hip replacement surgery. There were 48 patients waiting for hip replacements who were asked to complete a questionnaire about sleep. They were also studied using actigraphy (monitoring human rest/activity cycles) and sleep diaries for 4 or 5 nights -- one month before and 3 months after hip replacement surgery. There was significant improvement in sleep after surgery. Researchers found that:
- 75% of patients said sleep was never or rarely disturbed after hip surgery.
- There was less time spent in bed and less activity during sleep after hip surgery.
- Sleep was more efficient and less fragmented after hip surgery.
Researchers concluded that hip replacement surgery afforded pain relief that clearly improved sleep, and in turn, improved the patient's quality of life.
What You Should Do
If you are experiencing sleep disturbance on a regular basis -- review your treatment plan with your doctor. Re-assess goals for pain management. Recognize that sleep disturbance is a sign that you need better pain control. Challenge your doctor to help you find solutions. You shouldn't have to settle for unrefreshing sleep, night after night.
Osteoarthritis and Sleep: The Johnston County Osteoarthritis Project. Allen KD et al. The Journal of Rheumatology. June 2008. An assessment of sleep disturbance in patients before and after total hip arthroplasty. Fielden J. The Journal of Arthroplasty. April 2003.
Osteoarthritis and Sleep: The Johnston County Osteoarthritis Project. Allen KD et al. The Journal of Rheumatology. June 2008.
An assessment of sleep disturbance in patients before and after total hip arthroplasty. Fielden J. The Journal of Arthroplasty. April 2003.