# Sleep Disturbance in Rheumatoid Arthritis: Phenotypes, Causes, and Impact

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $637,237

## Abstract

Project Summary/Abstract
 Self-reported sleep problems are common in rheumatoid arthritis (RA), but objectively-measured data on
sleep are lacking. Our preliminary data provide evidence of frequent self-reported sleep problems, existence of
objectively-identified sleep disturbances, and the association of those sleep disturbances with poor RA-specific
health outcomes. The proposed project will address the significant knowledge gaps surrounding sleep
disturbances in RA. Project aims are to: (1) identify risk factors associated with sleep disturbance and changes
in sleep disturbance in individuals with RA; (2) identify the short-term and longer-term longitudinal effects of
sleep disturbance and changes in sleep disturbances on health outcomes in RA; and (3) examine a biological
pathway unique to RA to explain the high prevalence of sleep disturbance in RA and associations with RA
outcomes. No previous studies have attempted to link the disruptions in inflammatory biomarkers and cortisol,
and the concomitant peaking of RA symptoms, with sleep disturbance or with disruption of circadian rest-
activity patterns. 150 individuals with RA will be enrolled and followed over 24 months. Baseline, 6- and 12-
month assessments will consist of 7-nights of actigraphy monitoring to measure sleep and circadian rest-
activity patterns; completion of sleep and symptom diaries; questionnaires to assess disease activity, pain,
fatigue, physical activity, and symptoms of depression; blood draws for inflammatory markers; and salivary
diurnal cortisol collection. Screening for other primary sleep disorders will be conducted at baseline. Follow-ups
18 and 24 months after baseline will continue monitoring sleep and outcomes with 7 nights of sleep monitoring
by actigraphy and completion of sleep/symptom diaries and questionnaires. Bi-weekly telephone check-ins will
be conducted to monitor use, dosage, and timing of glucocorticoids (GCs) and other medications. Innovative
components of the proposed project include objective measurements of sleep, detailed examination of the role
of GCs in sleep disturbance in RA, examination of the roles of inflammatory and hormonal biomarkers, and the
extended longitudinal assessments, which will permit examination of the potential reciprocal effects of sleep
disturbance, inflammation, circadian variation in cortisol, and RA symptoms and disease activity. The study
team includes a unique collaboration of investigators with expertise in rheumatology, sleep, immunology,
psychoneuroimmunology, and statistical methods. Data will yield insights into predictors and mechanistic
precursors of sleep disturbance, provide information regarding the impact of sleep disturbance on RA health
outcomes, and provide preliminary evidence for potential interventions. Understanding sleep disturbances in
RA is important because assessments of RA disease activity, as well as decisions on the use, timing and
evaluation of response to RA therapy, may be impacted by...

## Key facts

- **NIH application ID:** 9971335
- **Project number:** 5R01AR072040-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Patricia P Katz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $637,237
- **Award type:** 5
- **Project period:** 2017-07-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9971335

## Citation

> US National Institutes of Health, RePORTER application 9971335, Sleep Disturbance in Rheumatoid Arthritis: Phenotypes, Causes, and Impact (5R01AR072040-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9971335. Licensed CC0.

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