The Relationship Between Circadian Rhythm, Sleep Disorders, and Physical Activity in Pediatric Patients with Juvenile Idiopathic Arthritis

Abstract

Objective: Juvenile idiopathic arthritis (JIA) often presents with pain, fatigue, and restricted mobility, disrupting daily functioning in pediatric patients. Sleep disturbances are recognized as significant contributors to both well-being and disease progression. However, the relationships among sleep patterns, circadian preferences, and physical activity in children with JIA remain insufficiently characterized. This study seeks to clarify these associations by comparing children with JIA to healthy controls.Methods: Eighty-five participants aged 8 to 17 years were included, comprising 39 children diagnosed with JIA and 46 healthy controls matched for age and sex. Sleep patterns were assessed using the Children’s Sleep Habits Questionnaire, and chronotype was assessed using the Childhood Chronotype Questionnaire. The PAQ-C and PAQ-A instruments measured Physical activity levels. Group differences were analyzed, and regression models were applied to identify factors associated with sleep disturbances.Results: Children with JIA had poorer sleep quality, particularly requiring more time to initiate sleep. Chronotype distribution and physical activity levels did not differ significantly between groups. Notably, use of electronic devices for at least 30 minutes before bedtime was significantly associated with poorer sleep quality, whereas a diagnosis of JIA was not an independent predictor after adjustment.Conclusion: Sleep disturbances in children with JIA are influenced more by modifiable lifestyle factors than by the disease itself. Interventions targeting behaviors such as screen time before bedtime may improve sleep quality and should be incorporated into clinical management strategies.