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Sosso FAE, Matos E, Papadopoulos D. Social disparities in sleep health of African populations: A systematic review and meta-analysis of observational studies. Sleep Health 2023; 9:828-845. [PMID: 37880077 DOI: 10.1016/j.sleh.2023.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/29/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES To document the relationship between socioeconomic status (SES) and sleep health in African populations. METHODS Observational cross-sectional or cohort studies examining the association between SES indicators and sleep outcomes in participants from African countries were included. The search was performed in the MEDLINE, Embase, and Web of Science Core Collection electronic databases in June 2021. Selection, confounding, attrition/exclusion, detection, and selective reporting bias were assessed using the OHAT Risk of Bias Tool. Random effects meta-analysis was used for summarizing the effect estimates. RESULTS Forty-three reports were selected, having sampled 153,372 Africans from 26 countries. Education was the most frequent SES indicator and composite measures of sleep quality or disturbances was the most common sleep outcome. Low educational attainment was significantly associated with lower odds of short sleep (odds ratio [OR]=0.65, 95% confidence intervals [0.50, 0.84], p = .001) and higher odds of insomnia (OR=1.53, [1.18, 1.99], p = .001) or poor sleep quality (OR=1.60, [1.17, 2.18], p = .003). Low levels of income/assets were related to higher odds of insomnia (OR=1.38, [1.02, 1.86], p = .04) and low occupational/employment status was linked to lower odds of short sleep duration (OR=0.49, [0.30, 0.79], p = .004). CONCLUSIONS Socioeconomic disadvantage was a significant predictor of insomnia and poor sleep quality, while it was associated with longer sleep duration. Significant heterogeneity in terms of exposure and outcomes, scarcity of longitudinal designs, lack of objective outcome measurement, and low representation of rural samples and participants from low-income countries limit the quality of evidence.
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Affiliation(s)
| | - Elsa Matos
- Sleep Laboratory of Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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De Baets L, Runge N, Labie C, Mairesse O, Malfliet A, Verschueren S, Van Assche D, de Vlam K, Luyten FP, Coppieters I, Babiloni AH, Martel MO, Lavigne GJ, Nijs J. The interplay between symptoms of insomnia and pain in people with osteoarthritis: A narrative review of the current evidence. Sleep Med Rev 2023; 70:101793. [PMID: 37269784 DOI: 10.1016/j.smrv.2023.101793] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 04/28/2023] [Accepted: 05/10/2023] [Indexed: 06/05/2023]
Abstract
Osteoarthritis (OA) is a leading cause of disability worldwide and clinical pain is the major symptom of OA. This clinical OA-related pain is firmly associated with symptoms of insomnia, which are reported in up to 81% of people with OA. Since understanding the association between both symptoms is critical for their appropriate management, this narrative review synthesizes the existing evidence in people with OA on i) the mechanisms underlying the association between insomnia symptoms and clinical OA-related pain, and ii) the effectiveness of conservative non-pharmacological treatments on insomnia symptoms and clinical OA-related pain. The evidence available identifies depressive symptoms, pain catastrophizing and pain self-efficacy as mechanisms partially explaining the cross-sectional association between insomnia symptoms and pain in people with OA. Furthermore, in comparison to treatments without a specific insomnia intervention, the ones including an insomnia intervention appear more effective for improving insomnia symptoms, but not for reducing clinical OA-related pain. However, at a within-person level, treatment-related positive effects on insomnia symptoms are associated with a long-term pain reduction. Future longitudinal prospective studies offering fundamental insights into neurobiological and psychosocial mechanisms explaining the association between insomnia symptoms and clinical OA-related pain will enable the development of effective treatments targeting both symptoms.
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Affiliation(s)
- Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium.
| | - Nils Runge
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
| | - Céline Labie
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium; Division of Rheumatology, University Hospitals Leuven, Belgium
| | - Olivier Mairesse
- Department of Brain Body and Cognition (BBCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium; Sleep Laboratory and Unit for Chronobiology U78, Department of Psychiatry, Brugmann University Hospital, Université Libre de Bruxelles (ULB) and Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Research Foundation Flanders (FWO), Brussels, Belgium
| | - Sabine Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
| | - Dieter Van Assche
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium; Division of Rheumatology, University Hospitals Leuven, Belgium
| | - Kurt de Vlam
- Division of Rheumatology, University Hospitals Leuven, Belgium; Skeletal Biology & Engineering Research Center, Dept. of Development & Regeneration, KU Leuven, Belgium
| | - Frank P Luyten
- Skeletal Biology & Engineering Research Center, Dept. of Development & Regeneration, KU Leuven, Belgium
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; The Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
| | - Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, Québec, Canada; Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l'Île-de-Montréal) and University of Québec, Canada; Faculty of Dental Medicine, Université de Montréal, Québec, Canada
| | - Marc O Martel
- Division of Experimental Medicine, McGill University, Montreal, Québec, Canada; Faculty of Dentistry & Department of Anesthesia, McGill University, Canada
| | - Gilles J Lavigne
- Division of Experimental Medicine, McGill University, Montreal, Québec, Canada; Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l'Île-de-Montréal) and University of Québec, Canada; Faculty of Dental Medicine, Université de Montréal, Québec, Canada
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Center for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium
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Al Saleh J, Almoallim H, Elzorkany B, Al Belooshi A, Batouk O, Fathy M, Vainstein N, Kaki AM. Assessing the Burden of Osteoarthritis in Africa and the Middle East: A Rapid Evidence Assessment. Open Access Rheumatol 2023; 15:23-32. [PMID: 36945659 PMCID: PMC10024869 DOI: 10.2147/oarrr.s390778] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
Introduction/Objectives This rapid evidence assessment (REA) was conducted to assess the burden of weight-bearing joint osteoarthritis in the developing countries of Africa and the Middle East. Methods Our REA methodology used a standardized search strategy to identify observational studies, published between January 1, 2010, and April 23, 2020, reporting on outcomes pertaining to the epidemiology and humanistic or economic burden of weight-bearing osteoarthritis. Relevant data from the included studies were used for qualitative analysis. Results Among the 20 publications reporting on knee osteoarthritis in 10 countries in Africa and the Middle East, 2 also reported on hip, and 1 on foot osteoarthritis. Prevalence of symptomatic/radiographic knee OA was 9-14% among rheumatology outpatients and 31-34% among those with mixed etiology osteoarthritis. Prevalence of knee OA diagnosed by magnetic resonance imaging was 70% among patients ≥40 years of age attending a hospital in Saudi Arabia. Quality-of-life outcomes were reported in 16 publications and suggested a substantial humanistic burden of osteoarthritis, including worse pain, function, and quality of life, and more depression; comparisons between studies were hampered by the variety of tools and scoring scales used, however. No studies reported on economic outcomes. Conclusion This REA indicates a substantial burden of osteoarthritis in weight-bearing joints in Africa and the Middle East, consistent with publications from other regions of the world.
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Affiliation(s)
- Jamal Al Saleh
- Department of Rheumatology, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Hani Almoallim
- Department of Medicine, Medical College, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Ali Al Belooshi
- Mediclinic City Hospital, Department of Surgery, UAE University, Dubai, United Arab Emirates
| | - Omar Batouk
- King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Jeddah, Saudi Arabia
| | | | | | - Abdullah M Kaki
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Correspondence: Abdullah M Kaki, MD, FRCPC, Professor of Anesthesiology and Pain Medicine, Faculty of Medicine, King Abdulaziz University, PO Box 2907, Jeddah, 21461, Saudi Arabia, Tel/Fax +966126408335, Email ;
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Bartosiak K, Schwabe M, Lucey B, Lawrie C, Barrack R. Sleep Disturbances and Disorders in Patients with Knee Osteoarthritis and Total Knee Arthroplasty. J Bone Joint Surg Am 2022; 104:1946-1955. [PMID: 35926180 DOI: 10.2106/jbjs.21.01448] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ There is increasing evidence that patient-reported outcomes following total knee arthroplasty (TKA) are associated with psychosocial factors and pain catastrophizing. Sleep disturbance, pain, and mental health have a complex interaction, which, if unrecognized, can be associated with impaired patient-reported outcomes and dissatisfaction following TKA. ➤ The gold standard of objective sleep assessment is polysomnography, which is not feasible to use routinely for TKA patients. Wearable devices are a validated and less costly alternative. ➤ Subjective sleep measures, such as the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, or Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive test sleep domains, are simple to administer and provide additional insight into sleep disturbance. Although objective and subjective measures do not correlate precisely, they can be informative together. ➤ Sleep disturbances in the elderly population are common and multifactorial in etiology, stemming from the interplay of sleep disorders, medication side effects, and pain. Commonly prescribed medications following TKA as well as postoperative pain can exacerbate underlying sleep disturbances. ➤ Obstructive sleep apnea (OSA) is prevalent in patients seeking TKA. In the setting of OSA, postoperative opioids can cause respiratory depression, resulting in consequences as severe as death. A standardized multimodal pain protocol including anti-inflammatories and gamma-aminobutyric acid (GABA) analogues may allow for decreased reliance on opioids for pain control. ➤ Surgeons should reassure patients that postoperative sleep disturbance is common and transient, collaborate with the patient's primary care doctor to address sleep disturbance, and avoid prescription of pharmaceutical sleep aids.
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Affiliation(s)
- Kimberly Bartosiak
- Department of Orthopaedics, Washington University in St. Louis, St. Louis, Missouri
| | - Maria Schwabe
- Department of Orthopaedics, Washington University in St. Louis, St. Louis, Missouri
| | - Brendan Lucey
- Department of Orthopaedics, Washington University in St. Louis, St. Louis, Missouri
| | - Charles Lawrie
- Miami Orthopedics & Sports Medicine Institute, Baptist Health South Florida, Miami, Florida
| | - Robert Barrack
- Department of Orthopaedics, Washington University in St. Louis, St. Louis, Missouri
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Yap AU, Zhang XH, Cao Y, Fu KY. Degenerative temporomandibular joint diseases and their relation with sleep and emotional disturbance. Cranio 2022:1-8. [PMID: 35285424 DOI: 10.1080/08869634.2022.2050976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The relation of degenerative temporomandibular joint (TMJ) diseases (DJDs) with sleep and emotional disturbance were investigated. METHODS CBCT examination of patients (n = 358) with DC/TMD-defined intra-articular temporomandibular disorders was performed and stratified into NN: no DJD and no arthralgia; NA: no DJD with arthralgia; TO: osteoarthrosis; and TR: osteoarthritis. Sleep and emotional disturbance were assessed with the Pittsburgh Sleep Quality Index (PSQI) and Depression Anxiety Stress Scale-21 (DASS-21). Data were evaluated using non-parametric and multivariate logistic regression analyses (α = 0.05). RESULTS Distributions of NN, NA, TO, and TR groups were 23.2%, 27.1%,19.0%, and 30.7%, respectively. No significant differences in total-PSQI/DASS scores were detected among the four groups. The presence of pain and stress predicted poor quality sleep with odds ratios of 10.75 and 1.07, accordingly. CONCLUSION Sleep quality was affected more by arthralgia and stress than the presence of TMJ DJDs.
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Affiliation(s)
- Adrian Ujin Yap
- Center for TMD & Orofacial Pain, Peking University, Hospital & School of Stomatology, Beijing, BJ, China
- Department of Dentistry, Ng Teng Fong General Hospital, Jurong East, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Center Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore
| | - Xian-Han Zhang
- Center for TMD & Orofacial Pain, Peking University, Hospital & School of Stomatology, Beijing, BJ, China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology: National Clinical Research Center for Oral Diseases, Beijing, BJ, China
| | - Ye Cao
- Center for TMD & Orofacial Pain, Peking University, Hospital & School of Stomatology, Beijing, BJ, China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology: National Clinical Research Center for Oral Diseases, Beijing, BJ, China
| | - Kai-Yuan Fu
- Center for TMD & Orofacial Pain, Peking University, Hospital & School of Stomatology, Beijing, BJ, China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology: National Clinical Research Center for Oral Diseases, Beijing, BJ, China
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Chu P, Ju YES, Hinze AM, Kim AH. Measures of Sleep in Rheumatologic Diseases: Sleep Quality Patient-Reported Outcomes in Rheumatologic Diseases. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:410-430. [PMID: 33091275 PMCID: PMC7586459 DOI: 10.1002/acr.24238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Philip Chu
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Yo-El S. Ju
- Sleep Medicine Center, Department of Neurology, Washington University School of Medicine, Saint Louis, MO
| | - Alicia M. Hinze
- Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Alfred H.J. Kim
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, Saint Louis, MO
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