Anxiety symptoms predict poor sleep quality in children with juvenile idiopathic arthritis

Birgitte Mahler; Johanne Jeppesen Lomholt; Troels Herlin

doi:10.1186/s12969-018-0265-6

Anxiety symptoms predict poor sleep quality in children with juvenile idiopathic arthritis

Birgitte Mahler, Johanne Jeppesen Lomholt, Troels Herlin

Department of Clinical Medicine - Department of Paediatrics
Department of Psychology and Behavioural Sciences - CEBU - Centre for the Psychological Treatment of Children and Adolescents

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Conference abstract in journal › Research › peer-review

Abstract

Introduction: Poor sleep quality is common in children with juvenile idiopathic arthritis (JIA). Sleep quality is affected by the child’s activity in disease and experience of pain. Psychological variables seem to have an impact on the sleep quality as well. Objectives: The aim of this study was to examine how pain, disease activity, and psychological wellbeing differs in children with JIA with poor or normal sleep quality, and the likelihood of these variables on having poor sleep quality. Methods: In the outpatient clinic patients diagnosed with JIA age 6-16 were included. Child and a parent completed questionnaires regarding the child’s sleep quality in The Children’s Sleep Habits Questionnaire (CSHQ), anxiety symptoms in Spence Children’s Anxiety Scale (SCAS), wellbeing in WHO-5 Wellbeing Index (WHO-5)), positive and negative mood in The Positive and Negative Affect Schedule (PANAS). Pain intensity was measured using the VAS 1-10 scale from the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Disease activity was calculated as JADAS-27. Exclusion criteria were JIA in remission off medication, co-morbidity, non- Danish speaking patients. Results: In total 62 patients were included. Results indicated that 55% of the children reported poor sleep quality (CSHQ>41). Children with poor sleep quality reported significant lower level of wellbeing and higher levels of anxiety, negative mood, and pain intensity, and showed higher level of disease activity (p =.02-.001). A logistic regression was performed to ascertain the effect of pain, disease activity, wellbeing, anxiety, and negative mood on the likelihood, that the children had poor sleep quality. The model was statistically significant (chi2 (4) = 16.50, p=.006) and explained 36.4% of the variance in poor sleep quality and correctly classified 75.5% of cases. Increasing level of anxiety symptoms was significantly associated with an increased likelihood of poor sleep quality (p=.01). None of the other predictor variables made a unique, significant contribution. Conclusion: Disease activity, pain, and psychological wellbeing were negatively affected in children with poor sleep quality. Especially the level of anxiety symptoms were a significant predictor of having poor sleep quality, which highlights the importance of focusing on the impact of anxiety and worry on children’s sleep quality.

Original language	English
Article number	P399
Journal	Pediatric Rheumatology
Volume	16
Issue	52
ISSN	1546-0096
DOIs	https://doi.org/10.1186/s12969-018-0265-6
Publication status	Published - 2018

Keywords

anxiety
Sleep disorder
Juvenile Idiopathic Arthritis

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10.1186/s12969-018-0265-6

https://link.springer.com/content/pdf/10.1186%2Fs12969-018-0265-6.pdf

Cite this

@article{8012e34cfa17472c86a0ba4ebf10f2f8,

title = "Anxiety symptoms predict poor sleep quality in children with juvenile idiopathic arthritis",

abstract = "Introduction: Poor sleep quality is common in children with juvenile idiopathic arthritis (JIA). Sleep quality is affected by the child{\textquoteright}s activity in disease and experience of pain. Psychological variables seem to have an impact on the sleep quality as well. Objectives: The aim of this study was to examine how pain, disease activity, and psychological wellbeing differs in children with JIA with poor or normal sleep quality, and the likelihood of these variables on having poor sleep quality. Methods: In the outpatient clinic patients diagnosed with JIA age 6-16 were included. Child and a parent completed questionnaires regarding the child{\textquoteright}s sleep quality in The Children{\textquoteright}s Sleep Habits Questionnaire (CSHQ), anxiety symptoms in Spence Children{\textquoteright}s Anxiety Scale (SCAS), wellbeing in WHO-5 Wellbeing Index (WHO-5)), positive and negative mood in The Positive and Negative Affect Schedule (PANAS). Pain intensity was measured using the VAS 1-10 scale from the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Disease activity was calculated as JADAS-27. Exclusion criteria were JIA in remission off medication, co-morbidity, non- Danish speaking patients. Results: In total 62 patients were included. Results indicated that 55% of the children reported poor sleep quality (CSHQ>41). Children with poor sleep quality reported significant lower level of wellbeing and higher levels of anxiety, negative mood, and pain intensity, and showed higher level of disease activity (p =.02-.001). A logistic regression was performed to ascertain the effect of pain, disease activity, wellbeing, anxiety, and negative mood on the likelihood, that the children had poor sleep quality. The model was statistically significant (chi2 (4) = 16.50, p=.006) and explained 36.4% of the variance in poor sleep quality and correctly classified 75.5% of cases. Increasing level of anxiety symptoms was significantly associated with an increased likelihood of poor sleep quality (p=.01). None of the other predictor variables made a unique, significant contribution. Conclusion: Disease activity, pain, and psychological wellbeing were negatively affected in children with poor sleep quality. Especially the level of anxiety symptoms were a significant predictor of having poor sleep quality, which highlights the importance of focusing on the impact of anxiety and worry on children{\textquoteright}s sleep quality.",

keywords = "anxiety, Sleep disorder, Juvenile Idiopathic Arthritis",

author = "Birgitte Mahler and Lomholt, {Johanne Jeppesen} and Troels Herlin",

year = "2018",

doi = "10.1186/s12969-018-0265-6",

language = "English",

volume = "16",

journal = "Pediatric Rheumatology ",

issn = "1546-0096",

publisher = "BMC",

number = "52",

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Anxiety symptoms predict poor sleep quality in children with juvenile idiopathic arthritis. / Mahler, Birgitte; Lomholt, Johanne Jeppesen ; Herlin, Troels.
In: Pediatric Rheumatology , Vol. 16, No. 52, P399, 2018.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Conference abstract in journal › Research › peer-review

TY - ABST

T1 - Anxiety symptoms predict poor sleep quality in children with juvenile idiopathic arthritis

AU - Mahler, Birgitte

AU - Lomholt, Johanne Jeppesen

AU - Herlin, Troels

PY - 2018

Y1 - 2018

N2 - Introduction: Poor sleep quality is common in children with juvenile idiopathic arthritis (JIA). Sleep quality is affected by the child’s activity in disease and experience of pain. Psychological variables seem to have an impact on the sleep quality as well. Objectives: The aim of this study was to examine how pain, disease activity, and psychological wellbeing differs in children with JIA with poor or normal sleep quality, and the likelihood of these variables on having poor sleep quality. Methods: In the outpatient clinic patients diagnosed with JIA age 6-16 were included. Child and a parent completed questionnaires regarding the child’s sleep quality in The Children’s Sleep Habits Questionnaire (CSHQ), anxiety symptoms in Spence Children’s Anxiety Scale (SCAS), wellbeing in WHO-5 Wellbeing Index (WHO-5)), positive and negative mood in The Positive and Negative Affect Schedule (PANAS). Pain intensity was measured using the VAS 1-10 scale from the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Disease activity was calculated as JADAS-27. Exclusion criteria were JIA in remission off medication, co-morbidity, non- Danish speaking patients. Results: In total 62 patients were included. Results indicated that 55% of the children reported poor sleep quality (CSHQ>41). Children with poor sleep quality reported significant lower level of wellbeing and higher levels of anxiety, negative mood, and pain intensity, and showed higher level of disease activity (p =.02-.001). A logistic regression was performed to ascertain the effect of pain, disease activity, wellbeing, anxiety, and negative mood on the likelihood, that the children had poor sleep quality. The model was statistically significant (chi2 (4) = 16.50, p=.006) and explained 36.4% of the variance in poor sleep quality and correctly classified 75.5% of cases. Increasing level of anxiety symptoms was significantly associated with an increased likelihood of poor sleep quality (p=.01). None of the other predictor variables made a unique, significant contribution. Conclusion: Disease activity, pain, and psychological wellbeing were negatively affected in children with poor sleep quality. Especially the level of anxiety symptoms were a significant predictor of having poor sleep quality, which highlights the importance of focusing on the impact of anxiety and worry on children’s sleep quality.

AB - Introduction: Poor sleep quality is common in children with juvenile idiopathic arthritis (JIA). Sleep quality is affected by the child’s activity in disease and experience of pain. Psychological variables seem to have an impact on the sleep quality as well. Objectives: The aim of this study was to examine how pain, disease activity, and psychological wellbeing differs in children with JIA with poor or normal sleep quality, and the likelihood of these variables on having poor sleep quality. Methods: In the outpatient clinic patients diagnosed with JIA age 6-16 were included. Child and a parent completed questionnaires regarding the child’s sleep quality in The Children’s Sleep Habits Questionnaire (CSHQ), anxiety symptoms in Spence Children’s Anxiety Scale (SCAS), wellbeing in WHO-5 Wellbeing Index (WHO-5)), positive and negative mood in The Positive and Negative Affect Schedule (PANAS). Pain intensity was measured using the VAS 1-10 scale from the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Disease activity was calculated as JADAS-27. Exclusion criteria were JIA in remission off medication, co-morbidity, non- Danish speaking patients. Results: In total 62 patients were included. Results indicated that 55% of the children reported poor sleep quality (CSHQ>41). Children with poor sleep quality reported significant lower level of wellbeing and higher levels of anxiety, negative mood, and pain intensity, and showed higher level of disease activity (p =.02-.001). A logistic regression was performed to ascertain the effect of pain, disease activity, wellbeing, anxiety, and negative mood on the likelihood, that the children had poor sleep quality. The model was statistically significant (chi2 (4) = 16.50, p=.006) and explained 36.4% of the variance in poor sleep quality and correctly classified 75.5% of cases. Increasing level of anxiety symptoms was significantly associated with an increased likelihood of poor sleep quality (p=.01). None of the other predictor variables made a unique, significant contribution. Conclusion: Disease activity, pain, and psychological wellbeing were negatively affected in children with poor sleep quality. Especially the level of anxiety symptoms were a significant predictor of having poor sleep quality, which highlights the importance of focusing on the impact of anxiety and worry on children’s sleep quality.

KW - anxiety

KW - Sleep disorder

KW - Juvenile Idiopathic Arthritis

U2 - 10.1186/s12969-018-0265-6

DO - 10.1186/s12969-018-0265-6

M3 - Conference abstract in journal

SN - 1546-0096

VL - 16

JO - Pediatric Rheumatology

JF - Pediatric Rheumatology

IS - 52

M1 - P399

ER -

Anxiety symptoms predict poor sleep quality in children with juvenile idiopathic arthritis

Abstract

Keywords

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