Buy this Article for $10.95

Have a coupon or promotional code? Enter it here:

When you buy this you'll get access to the ePub version, a downloadable PDF, and the ability to print the full article.

Keywords

 

Authors

  1. Labyak, Susan E. PhD, RN
  2. Bourguignon, Cheryl PhD, RN
  3. Docherty, Sharron PhD, RN

Abstract

Children with juvenile rheumatoid arthritis (JRA) report poor sleep quality, daytime sleepiness, fatigue, anxiety, and altered mood. Sleep disturbances in school-aged children are an issue of serious concern. Children are at an age when sleep is of primary importance to physical and intellectual growth, and sleep disturbances that begin in childhood may persist into adulthood. In this article we will review what is currently known about sleep in children with JRA, the influence of medications on sleep quality, the potential impact of poor sleep quality on daily life issues, and complementary/alternative modalities that may be effective in reducing sleep disturbances.

 

Nearly 300,000 children in the United States have been diagnosed with arthritis, and juvenile rheumatoid arthritis (JRA) is the most prevalent form of connective tissue disease. 1 Recent findings show that sleep is disrupted in children with JRA. 2-5 They experience difficulty falling asleep, frequent night awakenings, early morning awakening, and excessive daytime sleepiness. While we know that sleep is disturbed in children with JRA, we do not know the severity of these sleep disturbances, nor do we know the extent to which sleep disturbances influence daytime sleepiness, performance, and behavioral emotional functioning.

 

Sleep disturbances and insufficient sleep in healthy children are typically associated with changes in behavior that include irritability, decreased attention span, distractibility, impulsivity, hyperactivity, excessive daytime sleepiness, chronic fatigue, decrements in daytime alertness and performance, and an increase in school absenteeism. 6,7 Sleep disturbances in the school-aged child can lead to difficulty concentrating in school, and subsequently result in secondary behavior problems in the classroom. Children may be labeled as "hyperactive" or "ADHD" when the primary underlying problem is poor sleep. 8 A report of the National Commission on Sleep Disorders Research notes that "the relative paucity of research on mechanisms, treatments, and prevention is disturbing" 8(p94) particularly given the prevalence of sleep disturbances in children (see Fig 1).

 

Sleep disturbances in school-aged children are an issue of serious concern. Children are at an age when sleep is of primary importance to physical and intellectual growth and development, and sleep disturbances that begin in childhood may persist into adolescence and adulthood. 8 In this article we will review what is currently known about sleep in children with JRA, the influence of medications used in the treatment of JRA on sleep quality, the potential impact of poor sleep quality on daily life issues, and complementary/alternative strategies that may be effective in reducing sleep disturbances.