Occurrence and assessment of chronic pain fatigue and sleep disturbance in axial spondyloarthritis patients

Background Axial spondyloarthritis is an inflammatory arthritis with low back pain that affects the axial skeleton and sacroiliac joints, with extra-articular manifestations. Features of axSpA include pain, stiffness, reduced mobility, fatigue, and sleep disturbance. Fatigue has a strong link to sle...

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Main Authors: Eman Abdel Ghani Sayed, Samer Samy, Faruk Ali Abdi, Anna Abou-Raya
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Alexandria Journal of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/20905068.2025.2460313
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author Eman Abdel Ghani Sayed
Samer Samy
Faruk Ali Abdi
Anna Abou-Raya
author_facet Eman Abdel Ghani Sayed
Samer Samy
Faruk Ali Abdi
Anna Abou-Raya
author_sort Eman Abdel Ghani Sayed
collection DOAJ
description Background Axial spondyloarthritis is an inflammatory arthritis with low back pain that affects the axial skeleton and sacroiliac joints, with extra-articular manifestations. Features of axSpA include pain, stiffness, reduced mobility, fatigue, and sleep disturbance. Fatigue has a strong link to sleep disorders, disease determining parameters, and poor psychological status. Fatigue and sleep disturbance induced by inflammatory pain affect the health-related quality of life.Objectives To determine the occurrence of chronic pain, fatigue, sleep disturbance in axSpA, and their influence on the health-related quality of life.Patients Forty patients with axSpA were diagnosed according to Spondyloarthritis International Society (ASAS) classification criteria. Patients with rheumatoid arthritis, cancer, liver disease, and severe sleep or psychiatric disorders were excluded.Methods Complete blood count, erythrocyte sedimentation rate, C-reactive protein (CRP), human leucocyticantigen-B27, plain x-ray, and magnetic resonance imaging of the sacroiliac joints were performed. Functional scores, patient index data, axial SpA disease activity index, perceived stress scale, hospital anxiety and depression scale, functional axial SpA index, Pittsburgh sleep quality index, visual analogue scale, health assessment questionnaire, euro level QoL-5 dimension-3 L, work limitation questionnaire, fatigue item of the BAS-DAI, and fatigue severity scale were analyzed.Results Elevated levels of ESR (19.08 ± 11.75) and CRP (10.28 ± 6.29) were highly associated with chronic pain and discomfort in axSpA. ESR (p = 0.001), CRP (p = 0.001), and PAPID3 (p = 0.001) showed a significant positive correlation. ASDAS (p = 0.014), PSS (p = 0.015), RAPID3 (p = 0.015), and HADS (p = 0.011) were highly related to sleep disturbance and were statistically significant. The relationship between fatigue, age, BMI, CRP, ESR, PSS, and HADS was not statistically significant.Conclusion The increased occurrence of sleep disorders, anxiety, depression, fatigue, and chronic pain and elevated ESR, CRP, HLA-B27, and disease activity scores with lowered QoL explain the association of these factors with disease comorbidities. Additionally, more support and appropriate management of axSpA would be necessary to prevent sleep disorders and their associated complications.
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spelling doaj-art-fff96c9db52744c48a63c61a1ec015dc2025-01-31T12:25:08ZengTaylor & Francis GroupAlexandria Journal of Medicine2090-50682090-50762025-12-016111710.1080/20905068.2025.2460313Occurrence and assessment of chronic pain fatigue and sleep disturbance in axial spondyloarthritis patientsEman Abdel Ghani Sayed0Samer Samy1Faruk Ali Abdi2Anna Abou-Raya3Rheumatology and Clinical Immunology, Faculty of Medicine, Alexandria University, EgyptEpidemiology Departments, Higher Institute of Public Health, Alexandra University, EgyptRheumatology and Clinical Immunology, Faculty of Medicine, Alexandria University, EgyptRheumatology and Clinical Immunology, Faculty of Medicine, Alexandria University, EgyptBackground Axial spondyloarthritis is an inflammatory arthritis with low back pain that affects the axial skeleton and sacroiliac joints, with extra-articular manifestations. Features of axSpA include pain, stiffness, reduced mobility, fatigue, and sleep disturbance. Fatigue has a strong link to sleep disorders, disease determining parameters, and poor psychological status. Fatigue and sleep disturbance induced by inflammatory pain affect the health-related quality of life.Objectives To determine the occurrence of chronic pain, fatigue, sleep disturbance in axSpA, and their influence on the health-related quality of life.Patients Forty patients with axSpA were diagnosed according to Spondyloarthritis International Society (ASAS) classification criteria. Patients with rheumatoid arthritis, cancer, liver disease, and severe sleep or psychiatric disorders were excluded.Methods Complete blood count, erythrocyte sedimentation rate, C-reactive protein (CRP), human leucocyticantigen-B27, plain x-ray, and magnetic resonance imaging of the sacroiliac joints were performed. Functional scores, patient index data, axial SpA disease activity index, perceived stress scale, hospital anxiety and depression scale, functional axial SpA index, Pittsburgh sleep quality index, visual analogue scale, health assessment questionnaire, euro level QoL-5 dimension-3 L, work limitation questionnaire, fatigue item of the BAS-DAI, and fatigue severity scale were analyzed.Results Elevated levels of ESR (19.08 ± 11.75) and CRP (10.28 ± 6.29) were highly associated with chronic pain and discomfort in axSpA. ESR (p = 0.001), CRP (p = 0.001), and PAPID3 (p = 0.001) showed a significant positive correlation. ASDAS (p = 0.014), PSS (p = 0.015), RAPID3 (p = 0.015), and HADS (p = 0.011) were highly related to sleep disturbance and were statistically significant. The relationship between fatigue, age, BMI, CRP, ESR, PSS, and HADS was not statistically significant.Conclusion The increased occurrence of sleep disorders, anxiety, depression, fatigue, and chronic pain and elevated ESR, CRP, HLA-B27, and disease activity scores with lowered QoL explain the association of these factors with disease comorbidities. Additionally, more support and appropriate management of axSpA would be necessary to prevent sleep disorders and their associated complications.https://www.tandfonline.com/doi/10.1080/20905068.2025.2460313Axial spondyloarthritisfatiguesleep disturbancechronic pain
spellingShingle Eman Abdel Ghani Sayed
Samer Samy
Faruk Ali Abdi
Anna Abou-Raya
Occurrence and assessment of chronic pain fatigue and sleep disturbance in axial spondyloarthritis patients
Alexandria Journal of Medicine
Axial spondyloarthritis
fatigue
sleep disturbance
chronic pain
title Occurrence and assessment of chronic pain fatigue and sleep disturbance in axial spondyloarthritis patients
title_full Occurrence and assessment of chronic pain fatigue and sleep disturbance in axial spondyloarthritis patients
title_fullStr Occurrence and assessment of chronic pain fatigue and sleep disturbance in axial spondyloarthritis patients
title_full_unstemmed Occurrence and assessment of chronic pain fatigue and sleep disturbance in axial spondyloarthritis patients
title_short Occurrence and assessment of chronic pain fatigue and sleep disturbance in axial spondyloarthritis patients
title_sort occurrence and assessment of chronic pain fatigue and sleep disturbance in axial spondyloarthritis patients
topic Axial spondyloarthritis
fatigue
sleep disturbance
chronic pain
url https://www.tandfonline.com/doi/10.1080/20905068.2025.2460313
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