Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

Physical Activity and Frequent Sleep Insufficiency Among US Adults with Arthritis.

Hootman1,  Jennifer M., Carroll2,  Dianna, McKnight-Eily2,  Lela, Allen3,  Kelli D.

Centers for Disease Control and Prevention, Kennesaw, GA
Centers for Disease Control and Prevention, Atlanta, GA
Duke and Durham VA Medical Center, Durham, NC


Sleep problems occur in 30–80% of adults with arthritis. Physical activity may be a non-pharmaceutical approach to improving sleep. The purpose of this study was to assess the prevalence of sleep insufficiency and its association with physical activity (PA) level among adults with self-reported doctor-diagnosed arthritis (ARTH).


Using the 2009 Behavioral Risk Factor Surveillance System (BRFSS, n=424,592; n=153,914 with ARTH) we calculated moderate-intensity-equivalent minutes/week (2*vigorous min/wk + moderate min/wk) of self-reported PA for each respondent. Three PA levels were defined as: Active (ACT) (>=150 min/wk), insufficiently active (INSUF) (>10 – 149 min/wk), and inactive (INACT) (no PA for at least 10 min/wk). Frequent sleep insufficiency (FSI) was defined as reporting not getting enough sleep or rest for 14 or more days in the past 30. Weighted prevalence estimates (%) and 95% confidence intervals (CI) were calculated accounting for the complex sample design. Multivariable logistic regression models (adjusted odds ratios, AOR) were used to assess the association between PA level (INACT = referent) and FSI among adults with ARTH.


Among adults with arthritis, 32% reported 0 days, 36% 1–13 days, and 32% 14+ days (adults without arthritis 30%, 44%, and 26% respectively). [FIGURE] The prevalence of FSI was significantly higher (p<0.0001) among adults with ARTH (31.9%, CI 31.5–32.4) compared to adults without ARTH (25.9%, CI 25.6–26.3). Among adults with arthritis, FSI prevalence decreased as PA level increased (39.4% INACT, 31.1% INSUF, 29.9% ACT, p<0.0001). Compared to INACT, INSUF (crude OR=0.71, CI 0.67–0.75) and ACT (crude OR=0.75, CI 0.71–0.80) PA levels were associated with lower odds of FSI. These adjusted associations remained statistically significant (INSUF AOR=0.89, CI 0.84–0.95; ACT AOR=0.83, CI 0.77–0.89) after adjustment for demographic variables (age, sex, race/ethnicity, education), health status variables (body mass index, self-rated health, arthritis-attributable activity limitation, joint pain) and co-morbid conditions (diabetes, hypertension, heart disease, asthma, frequent mental distress).


1 in 3 adults with ARTH report FSI. Adults with ARTH meeting ACT levels of PA were 17% less likely to report FSI than INACT, suggesting physical activity may be a promising strategy to decrease FSI in this population. These findings need to be verified in prospective studies.

To cite this abstract, please use the following information:
Hootman, Jennifer M., Carroll, Dianna, McKnight-Eily, Lela, Allen, Kelli D.; Physical Activity and Frequent Sleep Insufficiency Among US Adults with Arthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2542

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