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Osteoarthritis, insomnia, and depression

Close up head shot of a woman sleepingOn World Suicide Prevention Day, learn more about the connection between osteoarthritis, insomnia, and depression. According to a recent study published in Arthritis Care & Research, pain, insomnia and depression were the main reasons for people living with osteoarthritis (OA) to schedule a visit with their doctor.

The study consisted of 2,976 people and half the participants had at least one of three symptoms: pain, insomnia, and depression. An estimated 34 percent of the patients studied experienced insomnia and 29 percent had depression, in addition to moderate to severe pain.

Dr. Minhui Liu is the lead author of the study and a research fellow at Johns Hopkins School of Nursing in Baltimore. His team found that among patients with osteoarthritis, about 47 percent of them reported moderate to severe pain, 17 percent clinical insomnia, and 21 percent clinical depression. In addition, about 13 percent of participants experienced moderate to severe pain and clinical insomnia at the same time, and 13 percent experienced moderate to severe pain and clinical depression at the same time. 

Dr. Liu concludes that there is a pain, sleep, and mood link connection, but it is not necessarily a synergistic one where one symptom affects the other. “From previous research, we know that OA pain, insomnia and depression interact with each other, and that one symptom may exacerbate the other. Given these complex interactions, we expected that some synergistic effects of these symptoms on healthcare use might exist in patients with OA. Our study did not detect such synergistic effects, which was surprising, but it is good from the patient’s perspective.”

Liu hopes that his stay will help inform patients with OA that OA pain may often go together with insomnia and mood issues so that they can proactively seek appropriate treatment. He added: “Patients with OA pain may derive additional benefit from treatment to improve sleep, as other research by my coauthors suggests that improving sleep in OA patients results in improved pain, depression, and fatigue.” Liu recommends that people with OA get screened for mood and sleep issues.

For patients with rheumatoid arthritis (RA), Liu cautions that his research study should be interpreted and generalized to RA patients with caution. “I would say some of these findings, like the high prevalence of pain, insomnia, and depression might apply to people living with RA and OA pain. However, how RA and OA pain interacts with insomnia and depression needs further investigation.”

If you are living with rheumatoid arthritis and want to learn more about depression as a symptom of arthritis, please read this JointHealth™ insight to learn more about some common strategies to alleviate depression.