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24-hour Activity and Sleep Profiles for Adults Living with Arthritis: Habits Matter


Arthritis Care Res (Hoboken). 2020 Oct 6. doi: 10.1002/acr.24424. Online ahead of print.

Lynne M Feehan 1, Na Lu 2, Hui Xie 2, Linda C Li 1

Author Information

1 Department of Physical Therapy, University of British Columbia, 212 Friedman Building, 2177 Wesbrook Mall, Vancouver, BC, Canada, V6T 1Z3.

2 Arthritis Research Centre of Canada, Richmond, Canada, British Columbia.


Objectives: Identify 24-hour activity-sleep profiles in adults with arthritis and explore factors associated with profile membership.

Methods: Cross-sectional cohort, using baseline data from two randomized trials studying activity counselling for people with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or knee osteoarthritis (OA). Participants wore activity monitors for 1-week and completed surveys for demographics, mood (Patient Health Questionnaire-9) and sitting and walking habits (Self-Reported Habit Index). 1440 minutes / day stratified into minutes off-body, sleeping, resting, non-ambulatory, and intermittent or purposeful ambulation. Latent class analysis determined cluster numbers; baseline-category multinomial logit regression identified factors associated with cluster membership.

Results: 172 people (RA: 51%, OA:30%, SLE: 19%). Clusters: High Sitters: 6.9 hours sleep, 1.6 hours rest, 13.2 hours non-ambulatory, 1.6 hours intermittent and 0.3 hours purposeful walking. Low Sleepers: 6.5 hours sleep, 1.2 hours rest, 12.2 hours non-ambulatory, 3.3 hours intermittent and 0.6 hours purposeful walking. High Sleepers: 8.4 hours sleep, 1.9 hours rest, 10.4 hours non-ambulatory, 2.5 hours intermittent and 0.3 hours purposeful walking. Balanced Activity: 7.4 hours sleep, 1.5 hours sleep, 9.4 hours non-ambulatory, 4.4 hours intermittent and 0.8 hours purposeful walking. Younger age [OR: 0.95 (95% CI: 0.91-0.99)], weaker occupational sitting habit [OR: 0.55 (95% CI: 0.41-0.76)] and stronger walking outside habit [OR: 1.43 (95% CI: (1.06-1.91)] were each associated with Balanced Activity relative to High Sitters.

Conclusions: Meaningful subgroups were identified based on 24-hour activity-sleep patterns. Suggesting tailoring interventions based on 24-hour activity-sleep profiles may be indicated, particularly in adults with stronger habitual sitting or weaker walking behaviors.