Straub, Rainer H. and Detert, Jaqueline and Dziurla, Rene and Fietze, Ingo and Loeschmann, Peter-Andreas and Burmester, Gerd R. and Buttgereit, Frank (2017) Inflammation Is an Important Covariate for the Crosstalk of Sleep and the HPA Axis in Rheumatoid Arthritis. NEUROIMMUNOMODULATION, 24 (1). pp. 11-20. ISSN 1021-7401, 1423-0216
Full text not available from this repository. (Request a copy)Abstract
Rheumatoid arthritis (RA) patients have sleep problems, and inflammation influences sleep. We demonstrated that sleep quality improves during intensified treatment with methotrexate (MTX) or etanercept (ETA). Since the hypothalamicpituitary-adrenal (HPA) axis is involved in sleep regulation, this study investigated the interrelation between sleep parameters, inflammation as objectified by C-reactive protein (CRP), and serum cortisol and adrenocorticotropic hormone (ACTH) levels. Thirty-one eligible patients (disease activity score, DAS28(CRP)>= 3.2) participated in a 16-week, open, prospective study of HPA axis outcomes. MTX was initiated in 15 patients (female-to-male ratio 9/6) and ETA in 16 patients (14/2). Clinical, laboratory (after polysomnography [PSG] between 8 and 9 a.m.), sleep (PSG), and HPA axis outcome parameters (after PSG between 8 and 9 a.m.) were recorded at baseline and week 16. Clinical characteristics of patients markedly improved throughout the study (e.g., DAS28(CRP) : p < 0.001; CRP: p < 0.001). Sleep efficiency and wake time after sleep onset markedly improved in the ETA group. Serum cortisol and ACTH did not change during observation. At baseline, serum cortisol levels were negatively correlated to sleep efficiency; this may depend on inflammation, because controlling for CRP eliminated this negative correlation. After ETA treatment, serum cortisol had a high positive correlation with total sleep time, sleep efficiency, and a negative correlation with wake time before and after sleep onset, which was not eliminated by controlling for CRP. In RA patients, the data indicate that inflammation is an important covariate for the crosstalk of sleep and the HPA axis. (C) 2017 S. Karger AG, Basel
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CORTICOTROPIN-RELEASING HORMONE; NECROSIS FACTOR THERAPY; PITUITARY-ADRENAL AXIS; IMMUNE-SYSTEM; CIRCADIAN-RHYTHM; CORTISOL; DEPRESSION; FATIGUE; QUALITY; NEUROENDOCRINE; Rheumatoid arthritis; Sleep; Intensive therapy; Anti-TNF therapy; Cortisol; Hypothalamic-pituitary-adrenal axis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:01 |
| Last Modified: | 19 Feb 2019 14:45 |
| URI: | https://pred.uni-regensburg.de/id/eprint/643 |
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