Healthy Sleep Pattern, Physical Activity May Help Reduce Rheumatoid Arthritis Risk

A healthy sleep pattern and moderate physical activity reduces the risk of developing rheumatoid arthritis (RA), according to study results published in BMC Medicine.

Recent evidence has suggested that modifiable lifestyle characteristics can have substantial effects on RA risk.

Researchers from Anhui Medical University in China sourced data for this study from the United Kingdom (UK) Biobank. Participants (N=363,211) were evaluated for incident RA through a median 12.5-year follow-up on the basis of sleep, physical activity, and genetic characteristics. Sleep scores were derived from 5 sleep components of duration, chronotype, insomnia, snoring, and excessive daytime sleepiness. A healthy sleep score was defined as a score of 4 or 5, intermediate sleep as a score of 2 or 3, and poor sleep as a score of one or less. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Low physical activity was defined as engaging in 600 metabolic equivalent (MET)-minutes per week or less, moderate activity as 600 to 3000 MET-minutes per week, and high activity as more than 3000 MET-minutes per week.

The study population had healthy (38.00%), intermediate (57.80%), and poor (4.20%) sleep patterns. Stratified by sleep pattern, all baseline characteristics differed significantly across groups, except for genetic risk score (GRS) for RA.

A total of 4262 cases of incident RA occurred during follow-up.

The risk for RA was significantly lower among individuals with healthy (adjusted hazard ratio [aHR], 0.61; P <.001) and intermediate (aHR, 0.76; P <.001) sleep patterns vs poor sleep. In which, lower risk for RA associated with never or rarely experiencing insomnia (aHR, 0.75; P <.001), not experiencing daytime sleepiness (aHR, 0.76; P <.001), and sleeping 7 to 8 hours per day (aHR, 0.77; P <.001).

Reduced RA risk was observed with moderate physical activity compared with low activity (aHR, 0.85; P <.001) and being in quartiles 2 (aHR, 0.89; P =.014), 3 (aHR, 0.84; P <.001), and 4 (aHR, 0.88; P =.010) of METs per week compared with quartile 1.

Risk for RA was related with genetic risk, in which RA associated with high (aHR, 2.30; P <.001) and moderate (aHR, 1.42; P <.001) GRS compared with low GRS.

Sleep, physical activity, and GRS all contributed to RA risk. Individuals with the highest risk for RA had high GRS and both unfavorable sleep and physical activity characteristics, in which their 10-year absolute risk for RA was 22.02 per 1000 person-years. Conversely, individuals with low GRS and both favorable sleep and physical activity characteristics had a risk of 4.54 per 1000 person-years.

These trends were robust in sensitivity analyses that accounted for subclinical RA, shift work, race and ethnicity, and air pollution.

Study limitations included the use of self-reported sleep and physical activity data and the assumption that sleep and physical activity behaviors were maintained through follow-up.

“A healthy sleep pattern and moderate [physical activity] were associated with a reduced risk of developing RA, which can offset the deleterious effects of predisposing genetic components,” the researchers concluded.