The moderating effect of sleep fragmentation on the association of sleep duration and pain in adults with sickle cell disease | oneSCDvoice
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The moderating effect of sleep fragmentation on the association of sleep duration and pain in adults with sickle cell disease

key information

source: The Journal of Pain

year: 2014

authors: G. Moscou-Jackson, P. Finan, C. Campbell, J. Haythornthwaite

summary/abstract:

Poor sleep is typically inversely associated with pain severity. However, the influence of sleep architecture on clinical pain has not yet been systematically investigated in adults living with Sickle Cell Disease (SCD). Daily diaries are the gold standard for assessing time-variant fluctuations of sleep and pain in daily life. The purpose of the present study was to examine the relationship between daily reports of SCD pain and parameters of sleep architecture, including total sleep time (TST), sleep onset latency (SOL), and wake after sleep onset (WASO). It was hypothesized that the relationship between TST and SCD pain would be qualified by levels of sleep fragmentation (i.e., WASO) and latency. Seventy-seven (77) adults with SCD completed daily morning (sleep) and evening (pain) diaries over a three-month period. Hierarchical linear model (HLM) with a random intercept was used to examine daily between-subjects and within-subjects effects of TST on SCD pain, as well as moderating effect of changes in WASO and SOL on pain over the study period. Results of the HLM analysis confirmed an inverse main effect of TST on self-reported pain whereby increasing TST was associated with decreased pain severity. Analyses also revealed a negative moderating effect of WASO, but not SOL, on the daily relationship between TST and pain. The moderating effect of WASO remained significant even after controlling for baseline depression and pain anxiety, two characteristics which are known to be positively associated with pain severity. These results suggest that both sleep duration and sleep fragmentation are associated with self-reported pain in adults with SCD. In particular, increased sleep duration has a positive effect on self-reported pain, but sleep fragmentation may diminish this effect. Taken together, the results suggest that reducing sleep fragmentation (WASO) may increase the positive benefit of increased sleep duration on pain.

organisation: Johns Hopkins University School of Nursing, Baltimore, MD

DOI: 10.1016/j.jpain.2014.01.060

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