Highlights
- •This study used daily diaries to examine sleep continuity and pain in adults with sickle cell disease.
- •Subjective parameters of sleep continuity predicted clinical pain severity.
- •Analgesic benefits of sleep duration may be qualified by sleep fragmentation.
Abstract
This analysis examined the influence of quantifiable parameters of daily sleep continuity,
primarily sleep duration and sleep fragmentation, on daily pain in adults with sickle
cell disease. Seventy-five adults with sickle cell disease completed baseline psychosocial
measures and daily morning (sleep) and evening (pain) diaries over a 3-month period.
Mixed-effect modeling was used to examine daily between- and within-subjects effects
of sleep continuity parameters on pain, as well as the synergistic effect of sleep
fragmentation and sleep duration on pain. Results revealed that nights of shorter
sleep duration and time in bed, increased fragmentation, and less efficient sleep
(relative to one's own mean) were followed by days of greater pain severity. Further,
the analgesic benefit of longer sleep duration was attenuated when sleep fragmentation
was elevated. These results suggest that both the separate and combined effects of
sleep duration and fragmentation should be considered in evaluating pain in adults
with sickle cell disease.
Perspective
Subjective parameters of sleep continuity (eg, sleep duration, fragmentation, and
efficiency) predict clinical pain in individuals with sickle cell disease. Additionally,
sleep duration should not be considered in isolation, and its association with pain
may be qualified by sleep fragmentation. Research and practice should include assessments
of both when addressing pain severity.
Key words
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Article info
Publication history
Published online: April 01, 2015
Accepted:
March 20,
2015
Received in revised form:
February 18,
2015
Received:
October 24,
2014
Footnotes
Supported by grants from the National Institutes of Health: National Heart, Lung, and Blood Institute Investigator Grant 5R01HL098110 (J.A.H.) and National Institute of Nursing Research Predoctoral Training Fellowships T32NR012704 and F31NR014598 (G.M.-J.).
The authors declare that they have no conflicts of interest.
Identification
Copyright
© 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.
