Sleep Quality in Well-defined Lyme Disease: A Clinical Cohort Study in Maryland, 2018, Bechtold et al

Andy · Feb 24, 2018

Abstract
Study Objectives
Lyme disease (LD) is the most common vector-borne disease in the United States. Approximately 5-15% of patients develop post-antibiotic treatment symptoms termed post-treatment LD syndrome (PTLDS). The primary objective of this study was to examine and quantify sleep quality among patients with early Lyme disease during the acute and convalescent periods, including among the subset who met criteria for PTLDS.

Methods
This paper draws from a clinical cohort study of early LD participants (n=122) and a sub-cohort of individuals who later met criteria for PTLDS (n=6). Participants were followed for one year after antibiotic treatment. The Pittsburgh Sleep Quality Index and standardized measures of pain, fatigue, depressive symptoms, and functional impact were administered at all visits for participants and controls (n=26). Participants meeting criteria for PTLDS at one-year post-treatment were compared to a subset of PSQI-defined poor-sleeping controls (n=10).

Results
At the pre-treatment visit, early LD participants reported poorer sleep than controls. By 6 months post-treatment, participant sleep scores as a group returned to control levels. PTLDS participants reported significantly worse global sleep and sleep disturbance scores and worse fatigue, functional impact, and more cognitive-affective depressive symptoms compared to poor-sleeping controls.

Conclusions
Participants with early LD experienced poor sleep quality, which is associated with typical LD symptoms of pain and fatigue. In the subset of patients who developed PTLDS, sleep quality remains affected for up to one year post-treatment and is commonly associated with pain. Sleep quality should be considered in the clinical picture for LD and PTLDS.
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Full access at https://academic.oup.com/sleep/advance-article/doi/10.1093/sleep/zsy035/4857241

duncan · Feb 24, 2018

This is an Aucott effort.

I couldn't help but notice they cite 5% to 15% of Lyme patients go on to develop so-called PTLDS. The commonly accepted range, for years now, has been 10% to 20%. But there is a revisionist movement within some of the most conservative fringes of Lyme establishment to drop that figure to no more than 5%. I wonder if the range noted in this study reflects that influence.

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Sleep Quality in Well-defined Lyme Disease: A Clinical Cohort Study in Maryland, 2018, Bechtold et al

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