• Kai Fu, Joanna Makovey, Ben Metcalf, Kim L Bennell, Yuqing Zhang, Rebecca Asher, Sarah R Robbins, Leticia A Deveza, Peter A Cistulli, and David J Hunter.
• From the Kolling Institute of Medical Research, Institute of Bone and Joint Research; Department of Rheumatology, and Department of Respiratory and Sleep Medicine, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Sydney, New South Wales; Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Victoria, Australia; Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard School of Medicine, Boston, Massachusetts, USA; National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney; Charles Perkins Centre, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. kafu7690@uni.sydney.edu.au.
• J Rheumatol. 2019 Nov 1; 46 (11): 1524-1530.

ObjectiveTo evaluate the association of sleep quality, sleep duration, and fatigue with hip pain exacerbations in persons with symptomatic hip osteoarthritis (OA).MethodsParticipants (n = 252) were followed for 90 days and asked to complete online questionnaires at 10-day intervals (control periods). A hip pain exacerbation (case periods) was defined as an increase of 2 points in pain intensity compared with baseline on a numeric rating scale (0-10). Subjective sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index, and fatigue was measured by Multidimensional Assessment of Fatigue in both periods. Univariable and multivariable conditional logistic regressions were used to assess the association.ResultsOf the 252 participants, 130 (52%) were included in the final analysis. Univariate association analysis showed that both poor sleep quality and greater fatigue were associated with increased odds of pain exacerbations (OR 1.72, 95% CI 1.04-2.86; OR 1.92, 95% CI 1.21-3.05, respectively). Short sleep duration was not associated with pain exacerbations. Poor sleep quality and greater fatigue remained associated with pain exacerbations after adjustment for physical activity and night pain levels in multivariable analysis. There was no significant interaction between sleep quality and fatigue (p = 0.21).ConclusionPoor sleep quality and greater fatigue were related to pain exacerbation in persons with symptomatic hip OA. Sleep disorders and fatigue should be considered when dealing with pain exacerbations.

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