Evidence map›Paper›PMID 41153815›Full record

ReviewBiomedicines2025

The Impact of Insomnia on the Clinical Course and Treatment Outcomes of Rheumatoid Arthritis.

Olivera Radmanović, Vladimir Janjić, Mirjana Veselinović, Aleksandar Kočović, Nemanja Murić, Milan Đorđić, Ermin Fetahović, Nikola Subotić, Anja Milojević, Milena Stojković and 3 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Biomedicines, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Olivera RadmanovićClinic for Rheumatology and Allergology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia.
Vladimir JanjićDepartment of Communication Skills, Ethics, and Psychology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.ORCID 0000-0001-6072-085X
Mirjana VeselinovićClinic for Rheumatology and Allergology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia.
Aleksandar KočovićDepartment of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.ORCID 0000-0001-9906-436X
Nemanja MurićDepartment of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.ORCID 0000-0003-1613-4778
Milan ĐorđićDepartment of Communication Skills, Ethics, and Psychology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.ORCID 0000-0003-2803-1469
Ermin FetahovićDepartment of Communication Skills, Ethics, and Psychology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.
Nikola SubotićDepartment of Neuroscience, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.
Anja MilojevićClinic for Rheumatology and Allergology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia.
Milena StojkovićDepartment of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.ORCID 0000-0002-7049-1082
Elvis MahmutovićDepartment of Biomedical Sciences, State University of Novi Pazar, 36300 Novi Pazar, Serbia.
Danijela DjokovićDepartment of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.
Branimir RadmanovićDepartment of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInsomnia is markedly more prevalent in rheumatoid arthritis (RA) patients than in the general population and is closely linked to pain, fatigue, psychological comorbidities, and systemic inflammation. Evidence suggests a bidirectional relationship, where active disease worsens sleep quality, while poor sleep amplifies inflammatory activity and symptom severity.

methodsA narrative review was conducted using PubMed, Scopus, Web of Science, and Embase to identify studies from the last 15 years involving adult RA patients. Inclusion criteria required assessment of insomnia or sleep quality in relation to disease activity, treatment outcomes, or inflammatory markers. Data from clinical trials, cohort studies, and reviews were synthesized to examine prevalence, mechanisms, and therapeutic implications.

resultsInsomnia affects up to 45% of RA patients and correlates with higher DAS28 scores, elevated CRP/ESR, increased pain sensitivity, and reduced quality of life. Contributing factors include chronic pain, stiffness, elevated IL-6 and TNF-α, depression, anxiety, and medication side effects. Conventional DMARDs, corticosteroids, and biologics indirectly improve sleep via inflammation control, with IL-6 inhibition showing potential sleep-specific benefits. Psychotropic agents may help in comorbid depression/anxiety but are best combined with cognitive behavioral therapy for insomnia (CBT-I).

conclusionsInsomnia is a prevalent, multifactorial problem in RA that adversely affects disease activity, symptom burden, and functional outcomes. Integrating sleep evaluation into routine RA management and adopting interdisciplinary strategies that address both inflammation and sleep disturbance may enhance patient outcomes. High-quality longitudinal studies using objective sleep measures are needed to clarify causal relationships and optimize therapy.

Indexed as

disease activityinflammationinsomniarheumatoid arthritissleep quality

Identifiers

PMID41153815
PMCPMC12561026

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.