DMARDs therapy may improve sleep and quality of life of elderly RA patients

Patients with rheumatoid arthritis (RA) had worse quality sleep than healthy individuals and with age, achieving a decent quality of life following therapy becomes gradually more challenging. According to a study published in Journal of Rheumatic Diseases, improvement in sleep and quality of life was more in older RA patients after DMARDs therapy.   

Azizli and co-researchers included 30 elderly patients with RA and healthy controls. The patients’ sleep and quality of life were assessed prior to and six months after receiving an RA diagnosis and DMARDs therapy. The study revealed that 67.6% of older patients reported having poor sleep quality before treatment, while the rate dropped to 26.5% after treatment. A significant difference was observed for subjective sleep quality, sleep latency, sleep length, sleep efficiency, and the score for sleep disturbances before and after therapy. Individuals with poor sleep quality had greater mean steroid doses and a higher disease activity score-28 than individuals with good sleep quality. Prior to and following therapy, there was a statistically significant change in terms of physical function, physical role difficulty, pain, emotional role difficulty, and energy/vitality. In comparison to the healthy control group, both sleep, and quality of life were lower in older RA patients before and after therapy. Additionally, RA patients’ poor sleep and quality of life are linked to aging and high disease activity. 

A clinical trial study by Zamarron et al., investigating infliximab’s impact on sleep quality, reported improvements in sleep and alertness disturbances following infliximab infusion in RA patients. Another prospective observational study by Taylor-Gjevre et al., comprising RA patients with hypersomnolence/poor sleep quality, reported that anti-TNF-therapy-treated RA patients showed improved sleep quality and reduced awakening after sleep onset time.  

Based on the study’s findings, it is evident that DMARDs therapy holds promise in enhancing sleep and improving the quality of life of elderly RA patients. Larger controlled investigations are needed to validate the study findings. 


  1. Azizli A, Sargın G, Senturk T. The effect of disease-modifying antirheumatic drugs on sleep and quality of life in older patients with rheumatoid arthritis. J Rheum Dis. 2023 Apr 1;30(2):99–105.  
  2. Zamarron C, Maceiras F, Mera A, Gomez-Reino JJ. Effect of the first infliximab infusion on sleep and alertness in patients with active rheumatoid arthritis. Ann Rheum Dis. 2004 Jan;63(1):88–90.  
  3. Taylor-Gjevre RM, Gjevre JA, Nair BV, Skomro RP, Lim HJ. Improved Sleep Efficiency after Anti-Tumor Necrosis Factor α Therapy in Rheumatoid Arthritis Patients. Ther Adv Musculoskelet Dis. 2011 Oct;3(5):227–33.