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Open Access Study protocol

Effect of intermittent aerobic exercise on sleep quality and sleep disturbances in patients with rheumatoid arthritis – design of a randomized controlled trial

Katrine Løppenthin12*, Bente Appel Esbensen13, Poul Jennum45, Mikkel Østergaard25, Jesper Frank Christensen6, Tanja Thomsen12, Julie Schjerbech Bech7 and Julie Midtgaard36

Author Affiliations

1 Research Unit of Nursing and Health Science, Glostrup Hospital, Copenhagen University, Copenhagen, Denmark

2 Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen University, Copenhagen, Denmark

3 Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

4 Danish Centre for Sleep Medicine, Department of Clinical Neurophysiology, Glostrup Hospital, Copenhagen University, Copenhagen, Denmark

5 Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

6 University Hospitals Centre for Health Care Research, Copenhagen University Hospital, Copenhagen, Denmark

7 Department of Rheumatology, Frederiksberg Hospital, Copenhagen University, Copenhagen, Denmark

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BMC Musculoskeletal Disorders 2014, 15:49  doi:10.1186/1471-2474-15-49

Published: 21 February 2014

Abstract

Background

Poor sleep is prevalent in patients with systemic inflammatory disorders, including rheumatoid arthritis, and, in addition to fatigue, pain, depression and inflammation, is associated with an increased risk of co-morbidity and all-cause mortality. Whereas non-pharmacological interventions in patients with rheumatoid arthritis have been shown to reduce pain and fatigue, no randomized controlled trials have examined the effect of non-pharmacological interventions on improvement of sleep in patients with rheumatoid arthritis. The aim of this trial was to evaluate the efficacy of an intermittent aerobic exercise intervention on sleep, assessed both objectively and subjectively in patients with rheumatoid arthritis.

Methods/design

A randomized controlled trial including 44 patients with rheumatoid arthritis randomly assigned to an exercise training intervention or to a control group. The intervention consists of 18 session intermittent aerobic exercise training on a bicycle ergometer three times a week. Patients are evaluated according to objective changes in sleep as measured by polysomnography (primary outcome). Secondary outcomes include changes in subjective sleep quality and sleep disturbances, fatigue, pain, depressive symptoms, physical function, health-related quality of life and cardiorespiratory fitness.

Discussion

This trial will provide evidence of the effect of intermittent aerobic exercise on the improvement of sleep in patients with rheumatoid arthritis, which is considered important in promotion of health and well-being. As such, the trial meets a currently unmet need for the provision of non-pharmacological treatment initiatives of poor sleep in patients with rheumatoid arthritis.

Trial registration

ClinicalTrials.gov Identifier: NCT01966835

Keywords:
Sleep quality; Sleep disturbances; Fatigue; Polysomnography; Cardiorespiratory fitness; Intermittent training; Rheumatoid arthritis