Sleep disturbances in outpatients with ankylosing spondylitis - a questionnaire study with gender implications

Objective: To study the sleep pattern in ankylosing spondylitis, and to inv estigate gender differences in sleep, pain, and fatigue. Methods: Forty-three male and 27 female patients with ankylosing spondyliti s completed a sleep questionnaire and the results were compared with earlie r findings in 3,558 persons randomly selected from the general population. Results: Too little sleep was reported by 80.8% of the female and 50.0% of the male patients, compared to 28.8% and 21.8% respectively in the referenc e group (p<0.0001). The main reason was pain in the pre-sleep and sleep-per iods (p<0.0001). Daytime fatigue was a major problem (p<0.0001). Higher cor relation was found between pain and daytime fatigue than between sleep dist urbance and daytime fatigue. Conclusion: Sleep disturbance is a significant problem in ankylosing spondy litis. The disturbance is closely related to pain at bedtime and during the night. Gender differences exist in the subjective sleep disturbance, fatig ue, and pain.