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Arthritis, Sleep Health, and Systemic Inflammation in Older Men

Author

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.

Abstract

OBJECTIVE: 

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

METHODS: 

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.

RESULTS: 

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.

CONCLUSION: 

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