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Arthritis, Sleep Health, and Systemic Inflammation in Older Men


Lee S1,2, Stone KL3,4, Engeland CG2,5,6, Lane NE7, Buxton OM2,5,8,9,10. Arthritis Care Res (Hoboken). 2019 May 10. doi: 10.1002/acr.23923. [Epub ahead of print]

Author Information

1 School of Aging Studies, University of South Florida.

2 Center for Healthy Aging, Pennsylvania State University.

3 Research Institute, California Pacific Medical Center, Sutter Bay Hospitals.

4 Department of Epidemiology and Biostatistics, University of California, San Francisco.

5 Department of Biobehavioral Health, Pennsylvania State University.

6 College of Nursing, Pennsylvania State University.

7 Center for Musculoskeletal Health/Medicine and Rheumatology, University of California, Davis.

8 Division of Sleep Medicine, Harvard Medical School.

9 Department of Social and Behavioral Sciences, Harvard Chan School of Public Health.

10 Sleep Health Institute, Departments of Medicine and Neurology, Brigham and Women's Hospital.



This study examined the associations of prevalent arthritis with systemic inflammation in older men, and tested whether sleep health mediates the associations.


Cross-sectional data came from 2,562 community-dwelling older men (all were 65 or older; Mage =76yrs) in the Osteoporotic Fractures in Men Study who participated in a sleep ancillary study in 2003-2005. Participants were classified as having osteoarthritis (OA; 24%) or rheumatoid arthritis (RA; 0.7%) based upon self-reported diagnoses and medication use. We constructed a composite score of multidimensional sleep health (i.e., perceived sleep quality, sleepiness, frequency of daytime napping, wake-after-sleep-onset, and sleep duration) measured by both self-report and actigraphy. We also created binary indicators of elevated inflammation using C-reactive protein (CRP; >3mg/L) and interleukin-6 (IL-6; >1.08pg/mL). Analyses controlled for age, diagnosed sleep disorders, BMI, smoking status, relevant medication use, and comorbidities.


Older men with OA did not have higher risk of elevated CRP or IL-6. However, indirect associations of OA through sleep health were found; OA was associated with poorer sleep health, which was further associated with 16% higher odds of elevated CRP (p<.001) and 12% higher odds of elevated IL-6 (p<.01), after controlling for OA. Older men with RA had higher odds of elevated CRP and IL-6, but the associations were not mediated by sleep health.


Findings suggest that promoting sleep health may help reduce the risk of systemic inflammation in older men with osteoarthritis.