Evidence on physical activity-sleep associations in axial spondyloarthritis: a scoping review of current findings.

INTRODUCTION

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease associated with pain, impaired function, and frequent sleep disturbances. While physical activity (PA) can improve symptoms and quality of life, persons with axSpA often have low PA levels. Despite the high prevalence of both sleep disturbances and reduced PA, evidence on their relationship remains limited.

OBJECTIVE

This review summarizes current knowledge on associations between sleep and PA in axSpA.

METHODS

This scoping review used a systematic search in PubMed, Web of Science, SPORTDiscus, and Cochrane Library. Studies including adults with axSpA reporting both PA and sleep outcomes were eligible. Methodological quality was assessed using a customized checklist for observational studies.

RESULTS

Of 69 records, three studies met the inclusion criteria: two relied on self-reported questionnaires, while one used a wearable device to measure PA and sleep. Individual-level analyses revealed heterogeneous relationships between PA and sleep. Spearman correlations identified significant associations in five different persons with axSpA: longer light sleep was associated with lower light or intense PA or fewer steps, while deep sleep was positively associated with moderate PA and negatively with low step counts. Subgroup discovery revealed individual-specific patterns in eight persons, showing that longer light sleep occurred under low PA or low step counts in some individuals, whereas shorter light sleep with higher step counts in others. Deep sleep increased with moderate PA or low step counts in certain individuals, while it decreased under very low steps or high light PA in others. Self-reported sleep disturbance was higher in persons with low PA.

CONCLUSION

This review highlights limited and heterogeneous evidence on the relationship between PA and sleep in axSpA. While preliminary findings suggest possible associations between PA intensity and sleep architecture, further longitudinal and interventional studies combining wearable-based and self-reported assessments are needed to clarify these relationships.