The purpose of this study was to describe and compare sleep quality and emotional behavioral functioning in children with and without Juvenile Idiopathic Arthritis (JIA). JIA is an inflammatory disease with unknown cause and one of the most common rheumatologic chronic conditions in children. Common disease symptoms include joint pain, inflammation, fatigue, and sleep disturbances. In a previous study, we found poor sleep quality (difficulty falling asleep, daytime sleepiness, sleep disordered breathing (SDB)) associated with JIA. Forty-six children (6-to-11 years) participated in the study, 23 were diagnosed with JIA and 23 were age-matched controls. Parents completed the Children’s Sleep Habits Questionnaire (CSHQ), a 45-item measure of their child’s sleep habits and quality over the previous week. The CSHQ yields a total sleep disturbance score (higher scores indicative of more disturbed sleep) and eight subscales: bedtime resistance, sleep-onset delay, sleep duration, sleep anxiety, night awakenings, parasomnias, SDB, and daytime sleepiness. Parents completed the Child Behavioral Checklist (CBCL), a 113-item retrospective report of their child’s behavior. CBCL yields scores for internalizing problem (i.e. somatic complaints) and externalizing problem (i.e. hyperactivity). Scores were summed and converted to age and gender adjusted T-scores (M = 50, SD = 10), higher scores suggesting greater behavior problems. Descriptive analyses were calculated on demographics, clinical characteristics, sleep disturbances, and behavior. T-test and X² procedures were used to examine study group differences (JIA and controls). We compared the proportion of children above the CSHQ clinical cutoff score (>41) to those below (<41) for overall sleep disturbance. Bivariate correlations and linear regressions were used to examine relations among age, medication, sleep variables, and CBCL behavior problems. Behavioral problems may stem from poor sleep quality in children with JIA. Findings from this study may heighten clinician awareness to assess sleep in children with JIA.

Juvenile Idiopathic Arthritis (JIA) is an autoimmune disease with an unknown cause. Children experience joint inflammation, pain, fatigue and sleep disturbances. Sleep disturbances such as sleep disordered breathing and insufficient amounts of sleep may contribute to lower quality of life and poor health outcomes in JIA. In a recent study from our laboratory 40% of a sample of children with JIA showed signs of sleep disordered breathing. The aim of this study is to describe and compare sleep disturbances in JIA and age, sex matched control children, and its relation to quality of life (QoL). Forty-six children (6-to-11 years) participated in the study. Of the 46 children, 23 were diagnosed with JIA and 23 were age-matched typically developing children. Parents completed the Children’s Sleep Habits Questionnaires (CSHQ), a 45-item measure of their child’s sleep habits and quality over the previous week. Children underwent 1 night of polysomnography in the UW School of Nursing sleep laboratory, and completed the Pediatric Quality of Life (PedsQL) questionnaire, a 23-item report that assesses health-related QoL (day-to-day activities) and disease specific symptoms. The specific domains include physical, emotional, social, and school function during the month prior to completion of the questionnaire. The PedsQL 4.0 yields a total score for overall health-related QoL, physical and psychosocial function and 4 subscales: physical, emotional, social, and school function. Data will be analyzed using SPSS for Windows version 18.0 (SPSS Inc, Chicago, Ill). Data analyses will be blocked into conceptual categories and then analyzed for group differences. Findings from this study may provide new knowledge about sleep disturbances and QoL in JIA children. Missed days from school and lower QoL in JIA often are attributed to pain and fatigue, but untreated sleep disturbances and sleep disorders may be an important etiology that is unrecognized by both clinicians and parents.