Sleep impairment: an obstacle to achieve optimal quality of life in rheumatoid arthritis

Sleep impairment is a common clinical condition in patients with rheumatoid arthritis. There are several confounding factors for poor sleep quality including inflammation, pain, comorbidities, and medications. Consequences of impaired sleep vary within a wide spectrum, as well. These include exacerbated inflammation and inflammation-related symptoms, mental and physical fatigue, mood disorders, daytime sleepiness, and poor quality of life. Sleep impairment in rheumatoid arthritis and its association with disease-related variables including health-related quality of life have been studied several times in the literature. Therefore, it would be of value to review the existing data on the crosstalk between sleep and rheumatoid arthritis. In the present article, the mechanism, confounders, and consequences of this association will be reviewed in detail. The evaluation of sleep impairment in rheumatoid arthritis along with the potential management strategies will be discussed.