Despite the best available clinical care, pain after surgery is a virtually universal patient experience that can have pervasive negative consequences. Given the large variability among patients in postoperative pain levels, research on novel modifiable risk factors is needed. One such factor suggested by recent experimental studies indicates that disruption of even a single night's sleep can increase subsequent pain in healthy volunteers. In this preliminary clinical study, we tested the hypothesis that poor sleep the night before surgery would predict heightened postoperative pain. Patients (n=24) scheduled for routine breast-conserving surgical procedures for the diagnosis or treatment of cancer were recruited and wore an actigraphy device providing objective, validated measures of sleep duration and disruption (low sleep efficiency). Pain severity and interference with daily activities for the week after surgery was assessed with the Brief Pain Inventory. As hypothesized, multiple regression analyses revealed that lower sleep efficiency was a significant predictor of greater pain severity and interference, controlling for age, race, and perioperative analgesics as appropriate. Sleep efficiency was not significantly related to measures of depressed mood, emotional upset, or relaxation assessed on the morning of surgery. Patients with sleep efficiency in the lowest tertile had clinically higher levels of pain (>2 points) compared with patients in the highest sleep efficiency tertile. Sleep duration had no significant effects. This preliminary clinical study supports the possibility that sleep disruption on the night before surgery may increase patients' experience of pain after surgery. Research to investigate the mechanisms underlying these effects and to explore the possible clinical benefits of interventions to improve patients' sleep before surgery is now warranted.
"Previous investigators evaluated relationships between symptoms and subjective sleep quality only. The magnitude of the correlations between sleep and fatigue, depression, pain, and anxiety ranged from 0.340 to 0.450, respectively, across seven studies [6, 50, 51]. Contrary to prior findings, TST was not associated with depression or fatigue . "
[Show abstract][Hide abstract] ABSTRACT: Background. Limited research has been conducted on the moderating effect of race/ethnicity on objective sleep disturbances in breast cancer survivors (BCSs). Objective. To explore racial/ethnic differences in objective sleep disturbances among BCSs and their relationship with self-reported symptoms. Intervention/Methods. Sleep disturbance and symptoms were measured using actigraphy for 72 hours and self-reported questionnaires, respectively, among 79 BCSs. Analysis of covariance, Pearson's correlation, and multivariate regression were used to analyze data. Results. Sixty (75.9%) participants listed their ethnicity as white, non-Hispanic and 19 (24.1%) as minority. Total sleep time was 395.9 minutes for white BCSs compared to 330.4 minutes for minority BCSs. Significant correlations were seen between sleep onset latency (SOL) and depression, SOL and fatigue, and sleep efficiency (SE) and fatigue among minority BCSs. Among white BCSs, significant correlations were seen between SE and pain and wake after sleep onset (WASO) and pain. The association between depression and SOL and fatigue and SOL appeared to be stronger in minority BCSs than white BCSs. Conclusions. Results indicate that white BCSs slept longer than minority BCSs, and race/ethnicity modified the effect of depression and fatigue on SOL, respectively. Implications for Practice. As part of survivorship care, race/ethnicity should be included as an essential component of comprehensive symptom assessments.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate preoperative sleep patterns in-patients scheduled for elective endoscopic surgery and
to compare sleep characteristics before different types of endoscopic procedures. A prospective survey cohort study (Canadian
Task Force classification II-2) was designed to evaluate quantitative and qualitative (score 1–7) sleep parameters. Patients
completed sleep-monitoring forms on the baseline (6weeks before surgery), two nights (night-2), and the night before surgery
(night-1). Of a total 119 women, 73 (61%) underwent laparoscopies and 46 (39%) hysteroscopies. Forty-seven (40%) operations
involved organ removal and 72 (60%) were reconstructive surgery. The mean overall sleep-quality score on night-1 (3.29 ± 0.15)
was higher (worse) than on baseline (2.09 ± 0.10, P < 0.0001) and night-2 (2.45 ± 0.11, P < 0.001, respectively). Patients reported more difficulty falling asleep on night-1 (2.53 ± 0.15) than on baseline (1.61 ± 0.09,
P < 0.0001) and night-2 (1.84 ± 0.12, P = 0.001, respectively). The mean number of nocturnal awaking events was also highest on night-1 (1.52 ± 0.17) than on baseline
(0.69 ± 0.09, P < 0.001) and night-2 (0.87 ± 0.09, P < 0.05 respectively). Using logistic regression, we found that age, stress level, and time before surgery (baseline, night-2,
night-1), were significant predictors of poor sleep. The type of planned surgery did not influence the quality of sleep. Falling
asleep on night-1 took longer than on baseline and night-2. There was no difference in the sleep quality measures between
the baseline and night-2. Poor sleep quality is common mainly in the night before surgery. The nature and extent of planned
surgery do not affect sleep quality variables.
Gynecological Surgery 05/2010; 8(2):151-155. DOI:10.1007/s10397-010-0639-3
[Show abstract][Hide abstract] ABSTRACT: During the past decade there has been an increasing interest on the impact and interaction of pain and sleep disturbance.
This chapter will present an overview of the growing literature on pain and insomnia, as well as a brief review of cognitive
behavioral treatment options. In the United States, 15-20% of the population experiences acute pain and 25-30% experiences
chronic pain. Almost a third adults experience at least one symptom a few nights or more per week according to the National
Sleep Foundation’s 2005 Sleep in America poll
It has been conservatively estimated that 28 million Americans experience sleep complaints in the context of a chronically
The pathophysiology of either condition and especially the comorbidity of the two have been poorly studied so have therapeutic
Given the immense impact of sleep and pain on individual’s and society, there is a need to further understand and explore
the pathways of sleep disturbance and pain.
KeywordsPain-Cognitive behavioral therapy-Insomnia-Pain medications
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.