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Predictors of Clinical Pain in Fibromyalgia: Examining the Role of Sleep
Anderson RJ, McCrae CS, Staud R, Berry RB, Robinson ME.
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida.
J Pain. 2012 Feb 29. [Epub ahead of print]
Abstract
Understanding individual differences in the variability of fibromyalgia pain can help elucidate etiological mechanisms and treatment targets. Past research has shown that spatial extent of pain, negative mood, and aftersensation (pain ratings taken after experimental induction of pain) accounts for 40 to 50% of the variance in clinical pain. Poor sleep is hypothesized to have a reciprocal relationship with pain, and over 75% of individuals with fibromyalgia report disturbed sleep. We hypothesized that measures of sleep would increase the predictive ability of the clinical pain model. Measures of usual pain, spatial extent of pain, negative mood, and pain aftersensation were taken from 74 adults with fibromyalgia. Objective (actigraph) and subjective (diary) measures of sleep duration and nightly wake time were also obtained from the participants over 14 days. Hierarchical regression indicated that greater spatial extent (R(2) = .26), higher aftersensation ratings (R(2) = .06), and higher negative mood (R(2) = .04) accounted for 36% of the variance in clinical pain (average of 14 daily pain ratings). None of the sleep variables were significant predictors of clinical pain. Results replicate previous research and suggest that spatial extent of pain, pain aftersensation, and negative mood play important roles in clinical pain, but sleep disturbance did not aid in its prediction. PERSPECTIVE: This study suggests that measures of sleep duration and nightly wake time do not predict fibromyalgia pain at the group level. Fibromyalgia patients may benefit from a 3-pronged approach to pain management: reducing pain's spatial extent, normalization of central nervous system hypersensitivity, and psychobehavioral therapies for negative mood.
Anderson RJ, McCrae CS, Staud R, Berry RB, Robinson ME.
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida.
J Pain. 2012 Feb 29. [Epub ahead of print]
Abstract
Understanding individual differences in the variability of fibromyalgia pain can help elucidate etiological mechanisms and treatment targets. Past research has shown that spatial extent of pain, negative mood, and aftersensation (pain ratings taken after experimental induction of pain) accounts for 40 to 50% of the variance in clinical pain. Poor sleep is hypothesized to have a reciprocal relationship with pain, and over 75% of individuals with fibromyalgia report disturbed sleep. We hypothesized that measures of sleep would increase the predictive ability of the clinical pain model. Measures of usual pain, spatial extent of pain, negative mood, and pain aftersensation were taken from 74 adults with fibromyalgia. -
Bidirectional interactions between circadian entrainment and cognitive performance
Gritton HJ, Kantorowski A, Sarter M, Lee TM.
Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA 48109-1043.
Learn Mem. 2012 Mar 1;19(3):126-41. doi: 10.1101/lm.023499.111.
Abstract
Circadian rhythms influence a variety of physiological and behavioral processes; however, little is known about how circadian rhythms interact with the organisms' ability to acquire and retain information about their environment. These experiments tested whether rats trained outside their endogenous active period demonstrate the same rate of acquisition, daily performance, and remote memory ability as their nocturnally trained counterparts in tasks of sustained attention and spatial memory. Furthermore, we explored how daily task training influenced circadian patterns of activity. We found that rats demonstrate better acquisition and performance on an operant task requiring attentional effort when trained during the dark-phase. Time of day did not affect acquisition or performance on the Morris water maze; however, when animals were retested 2 wk after their last day of training, they showed better remote memory if training originally occurred during the dark-phase. Finally, attentional, but not spatial, task performance during the light-phase promotes a shift toward diurnality and the synchronization of activity to the time of daily training; this shift was most robust when the demands on the cognitive control of attention were highest. Our findings support a theory of bidirectional interactions between cognitive performance and circadian processes and are consistent with the view that the circadian abnormalities associated with shift-work, aging, and neuropsychiatric illnesses may contribute to the deleterious effects on cognition often present in these populations. Furthermore, these findings suggest that time of day should be an important consideration for a variety of cognitive tasks principally used in psychological and neuroscience research.
Gritton HJ, Kantorowski A, Sarter M, Lee TM.
Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA 48109-1043.
Learn Mem. 2012 Mar 1;19(3):126-41. doi: 10.1101/lm.023499.111.
Abstract
Circadian rhythms influence a variety of physiological and behavioral processes; however, little is known about how circadian rhythms interact with the organisms' ability to acquire and retain information about their environment. These experiments tested whether rats trained outside their endogenous active period demonstrate the same rate of acquisition, daily performance, and remote memory ability as their nocturnally trained counterparts in tasks of sustained attention and spatial memory. Furthermore, we explored how daily task training influenced circadian patterns of activity. We found that rats demonstrate better acquisition and performance on an operant task requiring attentional effort when trained during the dark-phase. -
Subjective, anatomical, and functional nasal evaluation of patients with obstructive sleep apnea syndrome
de Aguiar Vidigal T, Martinho Haddad FL, Gregório LC, Poyares D, Tufik S, Azeredo Bittencourt LR.
Departamento de Otorrinolaringologia e Cirurgia de Cabeça Pescoço, Universidade Federal de São Paulo, Rua Pedro de Toledo, 551, 203B, CEP 04018001, São Paulo, SP, Brazil
Sleep Breath. 2012 Mar 3. [Epub ahead of print]
BACKGROUND:
Studies have shown a high occurrence of nasal alterations in patients with obstructive sleep apnea syndrome (OSAS), but no studies have used different methods to evaluate the nose of patients with OSAS. The objective of this study was to evaluate the nose of patients with OSAS, compare them to controls, and correlate the different methods used to evaluate the nose.METHODS:
Forty-seven patients with moderate/severe OSAS and 20 controls who were matched for gender, age, and body mass index were included. Questionnaires regarding sleep and nasal symptoms, physical examination, rhinoscopy, nasofibroscopy, nasal inspiratory peak flow (NIPF), and acoustic rhinometry (AR) measurements were performed.RESULTS:
In the OSAS group, 33 (70.2%) were male, with a mean age of 53.2 ± 9.1 years. In the control group, 13 (65%) were male, with a mean age of 53.7 ± 9.7 years. The OSAS group had a higher score on the nasal symptoms scale (p < 0.01) and a higher frequency of nasal alterations [presence of septal deviation, clinical complaints (p = 0.01) and hypertrophy of the inferior nasal turbinate (p < 0.01)]. The NIPF and AR parameters could not differentiate between the OSAS and control groups. There were no significant correlations among the different methods used to evaluate the nose. Lower NIPF values were capable of predicting higher apnea-hypopnea index scores (p = 0.007).CONCLUSION:
Clinical complaints and nasal alterations as measured by rhinoscopy and nasofibroscopy were associated with the presence of OSAS, which was not the case for the NIPF and AR parameters. The results of different evaluation methods were not correlated with each other.
de Aguiar Vidigal T, Martinho Haddad FL, Gregório LC, Poyares D, Tufik S, Azeredo Bittencourt LR.
Departamento de Otorrinolaringologia e Cirurgia de Cabeça Pescoço, Universidade Federal de São Paulo, Rua Pedro de Toledo, 551, 203B, CEP 04018001, São Paulo, SP, Brazil
Sleep Breath. 2012 Mar 3. [Epub ahead of print]
BACKGROUND:
Studies have shown a high occurrence of nasal alterations in patients with obstructive sleep apnea syndrome (OSAS), but no studies have used different methods to evaluate the nose of patients with OSAS. The objective of this study was to evaluate the nose of patients with OSAS, compare them to controls, and correlate the different methods used to evaluate the nose.METHODS:
Forty-seven patients with moderate/severe OSAS and 20 controls who were matched for gender, age, and body mass index were included. -
Sleep disturbances and fatigue: independent predictors of sickness absence? A prospective study among 6538 employees
Bültmann U, Nielsen MB, Madsen IE, Burr H, Rugulies R.
Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Eur J Public Health. 2012 Feb 29. [Epub ahead of print]
BACKGROUND:
Although sleep disturbances and fatigue are common conditions, frequently shown to be associated with sickness absence, only a few studies have prospectively investigated their independent effects on sickness absence, while adjusting for depressive symptoms. This study aims (i) to examine whether sleep disturbances and fatigue are independently related to the onset of register-based sickness absence of ≥3 weeks during a 1-year follow-up in a representative sample of the Danish workforce and (ii) to determine if possible associations are gender-specific.METHODS:
Data were used from the Danish Work Environment Cohort Study and linked with sickness absence data from the Danish National Register of Social Transfer Payments. A total of 6538 employees, 3178 men and 3360 women, were included in the analyses.RESULTS:
Sleep disturbances predicted risk of sickness absence after adjustment for covariates, but lost statistical significance after further adjustment for depressive symptoms. Fatigue among men predicted risk of sickness absence [Hazard ratio (HR) = 1.25, 95% confidence intervals (CI) 1.00-1.56] after adjustment for covariates, depressive symptoms and sleep disturbances.CONCLUSION:
Sleep disturbances in both genders and fatigue in women did not predict sickness absence after depressive symptoms were taken into account. In men, fatigue was significantly related to future sickness absence, also when adjusted for depressive symptoms and sleep disturbances. Further prospective studies are needed to explore the pathways from fatigue to sickness absence in more detail. The study suggests that early detection and treatment of fatigue in men should be high on the stakeholder's agenda.
Bültmann U, Nielsen MB, Madsen IE, Burr H, Rugulies R.
Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Eur J Public Health. 2012 Feb 29. [Epub ahead of print]
BACKGROUND:
Although sleep disturbances and fatigue are common conditions, frequently shown to be associated with sickness absence, only a few studies have prospectively investigated their independent effects on sickness absence, while adjusting for depressive symptoms. This study aims (i) to examine whether sleep disturbances and fatigue are independently related to the onset of register-based sickness absence of ≥3 weeks during a 1-year follow-up in a representative sample of the Danish workforce and (ii) to determine if possible associations are gender-specific. -
The role of presleep negative emotion in sleep physiology
Vandekerckhove M, Weiss R, Schotte C, Exadaktylos V, Haex B, Verbraecken J, Cluydts R.
Faculty of Psychological and Educational Sciences, Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium.
Psychophysiology. 2011 Dec;48(12):1738-44. doi: 10.1111/j.1469-8986.2011.01281.x. Epub 2011 Sep 6.
Abstract
Although daytime emotional stressful events are often presumed to cause sleep disturbances, the few studies of stressful life events on sleep physiology have resulted in various and contradictory findings. As research has focused in particular on stress in itself, the present study is the first to investigate the effect using polysomnography (PSG). Results indicate a significant increase in sleep fragmentation, as expressed by decreased sleep efficiency, total sleep time, percentage of rapid eye movement (REM) sleep, and an increased wake after sleep onset latency, total time awake, latency to SWS, number of awakenings and number of awakenings from REM sleep. The results demonstrate that negative emotion correlates with enhanced sleep fragmentation helping us to understand why sleep patterns change and how sleep disturbances may develop.
Vandekerckhove M, Weiss R, Schotte C, Exadaktylos V, Haex B, Verbraecken J, Cluydts R.
Faculty of Psychological and Educational Sciences, Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium.
Psychophysiology. 2011 Dec;48(12):1738-44. doi: 10.1111/j.1469-8986.2011.01281.x. Epub 2011 Sep 6.
Abstract
Although daytime emotional stressful events are often presumed to cause sleep disturbances, the few studies of stressful life events on sleep physiology have resulted in various and contradictory findings. As research has focused in particular on stress in itself, the present study is the first to investigate the effect using polysomnography (PSG). -
Evaluating the workload of on-call psychiatry residents: which activities are associated with sleep loss
Cooke BK, Cooke EO, Sharfstein SS.
Acad Psychiatry. 2012 Jan 1;36(1):43-6.
OBJECTIVE:
The purpose of this study was to review the workload inventory of on-call psychiatry residents and to evaluate which activities were associated with reductions in on-call sleep.METHOD:
A prospective cohort study was conducted, following 20 psychiatry residents at a 231-bed psychiatry hospital, from July 1, 2008 through June 30, 2009. On-call activities and hours of sleep received were recorded on log sheets.RESULTS:
From the 2008-2009 academic year, 298 on-call log sheets were received (81.64% response rate). The mean hours of sleep per night received by participating residents was 3.52 hours. The mean number of pages received was 17.21 per night. The variance in hours of sleep was explained by the number of pages and the number of admissions.CONCLUSION:
Given the new standards established by the Accreditation Council for Graduate Medical Education, residency directors can increase on-call sleep for residents by reducing the number of pages and admissions.
Cooke BK, Cooke EO, Sharfstein SS.
Acad Psychiatry. 2012 Jan 1;36(1):43-6.
OBJECTIVE:
The purpose of this study was to review the workload inventory of on-call psychiatry residents and to evaluate which activities were associated with reductions in on-call sleep.METHOD:
A prospective cohort study was conducted, following 20 psychiatry residents at a 231-bed psychiatry hospital, from July 1, 2008 through June 30, 2009. On-call activities and hours of sleep received were recorded on log sheets.RESULTS:
From the 2008-2009 academic year, 298 on-call log sheets were received (81.64% response rate). The mean hours of sleep per night received by participating residents was 3.52 hours. The mean number of pages received was 17.21 per night. The variance in hours of sleep was explained by the number of pages and the number of admissions. -
Night shift work characteristics and 6-sulfatoxymelatonin (MT6s) in rotating night shift nurses and midwives
Peplonska B, Bukowska A, Gromadzinska J, Sobala W, Reszka E, Lie JA, Kjuus H, Wasowicz W.
Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.
Occup Environ Med. 2012 Feb 25. [Epub ahead of print]
Abstract
ObjectivesSynthesis of melatonin follows a circadian cycle, with high melatonin levels during the night and low levels during the day. Light exposure at night has been hypothesised as one of potential mechanisms of breast carcinogenesis in the night shift workers through inhibition of melatonin synthesis. The aim of the study was to examine a number of determinants for night shift work in relation to 6-sulfatoxymelatonin (MT6s), primary melatonin metabolite.MethodsThe cross-sectional study included 354 nurses and midwives (aged 40-60 years) currently working on rotating night shifts and 370 working days only. Data from questionnaires and 1-week diaries were used to characterise current job and total occupational history. Associations between rotating night shift work characteristics and MT6s (creatinine adjusted) in spot morning urine were tested in multiple linear regression models.ResultsNo significant differences were found for MT6s concentrations between women currently working on rotating night shifts and those working only day shifts (means 47.2 vs 45.7 ng/mg Cr, respectively). The adjusted means among rotating night shift nurses and midwives varied depending on the department of employment, from 35.1 ng/mg Cr in neonatology to 68.2 ng/mg Cr in the orthopaedics department. Women working eight or more night shifts per month had significantly lower MT6s levels than those having fewer night shifts per month (37.9 vs 47.4 ng/mg Cr, respectively). Total night shift work history was not associated with MT6s.ConclusionsThe results of this study indicate that working eight or more night shifts per month may disrupt the synthesis of melatonin.
Peplonska B, Bukowska A, Gromadzinska J, Sobala W, Reszka E, Lie JA, Kjuus H, Wasowicz W.
Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.
Occup Environ Med. 2012 Feb 25. [Epub ahead of print]
Abstract
ObjectivesSynthesis of melatonin follows a circadian cycle, with high melatonin levels during the night and low levels during the day. Light exposure at night has been hypothesised as one of potential mechanisms of breast carcinogenesis in the night shift workers through inhibition of melatonin synthesis. The aim of the study was to examine a number of determinants for night shift work in relation to 6-sulfatoxymelatonin (MT6s), primary melatonin metabolite.MethodsThe cross-sectional study included 354 nurses and midwives (aged 40-60 years) currently working on rotating night shifts and 370 working days only. -
The better weight-better sleep study: a pilot intervention in primary care
Logue EE, Bourguet CC, Palmieri PA, Scott ED, Matthews BA, Dudley P, Chipman KJ.
Director, Family Medicine Research Center, Department of Family Medicine, Summa Health System, Akron, OH, USA.
Am J Health Behav. 2012 Mar;36(3):319-34.
OBJECTIVE:
To explore the feasibility of integrating sleep management interventions with dietary and exercise interventions for obesity in a 12-week randomized trial.METHODS:
We randomized 49 overweight or obese adult patients either to a better weight (BW) cognitive behavioral intervention, or to a combination of the BW intervention and a better sleep intervention, better weight-better sleep (BWBS).RESULTS:
The BWBS group lost weight faster (P=.04), and coping self-efficacy accelerated (P=.01).CONCLUSIONS:
These preliminary results merit replication in a larger primary care-based trial with a longer continuous intervention and follow-up period.
Logue EE, Bourguet CC, Palmieri PA, Scott ED, Matthews BA, Dudley P, Chipman KJ.
Director, Family Medicine Research Center, Department of Family Medicine, Summa Health System, Akron, OH, USA.
Am J Health Behav. 2012 Mar;36(3):319-34.
OBJECTIVE:
To explore the feasibility of integrating sleep management interventions with dietary and exercise interventions for obesity in a 12-week randomized trial.METHODS:
We randomized 49 overweight or obese adult patients either to a better weight (BW) cognitive behavioral intervention, or to a combination of the BW intervention and a better sleep intervention, better weight-better sleep (BWBS).RESULTS:
The BWBS group lost weight faster (P=.04), and coping self-efficacy accelerated (P=.01).CONCLUSIONS:
These preliminary results merit replication in a larger primary care-based trial with a longer continuous intervention and follow-up period. -
Effects of dietary weight loss on obstructive sleep apnea: a meta-analysis.
Anandam A, Akinnusi M, Kufel T, Porhomayon J, El-Solh AA.
Western New York Respiratory Research Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA.
Sleep Breath. 2012 Feb 29. [Epub ahead of print]
PURPOSE:
Clinical and epidemiologic investigations suggest a strong association between obesity and obstructive sleep apnea (OSA). The purpose of this study is to evaluate the currently available literature reporting on the effectiveness of dietary weight loss in treating OSA among obese patients.METHODS:
Relevant studies were identified by computerized searches of PubMed, EMBASE, CINAHL, Web of Science, and The Cochrane Central Register of Controlled Trials through September 2011 as well as the reference lists of all obtained articles. Information on study design, patient characteristics, pre- and post-dietary weight loss measures of OSA and body mass index (BMI), and study quality was obtained. Data were extracted by two independent analysts. Weighted averages using a random-effects model are reported with 95 % confidence intervals.RESULTS:
Nine articles representing 577 patients were selected. Dietary weight loss program resulted in a pooled mean BMI reduction of 4.8 kg/m(2) (95 % confidence interval [CI] 3.8-5.9). The random-effects pooled apnea hypopnea (AHI) indices at pre- and post-dietary intervention were 52.5 (range 10.0-91.0) and 28.3 events/h (range 5.4-64.5), respectively (p < 0.001). Compared to control, the weighted mean difference of AHI was decreased by -14.3 events/h (95 % CI -23.5 to -5.1; p = 0.002) in favor of the dietary weight loss programs.CONCLUSIONS:
Dietary weight loss programs are effective in reducing the severity of OSA but not adequate in relieving all respiratory events. Weight reduction programs should be considered as adjunct rather than curative therapy.
Anandam A, Akinnusi M, Kufel T, Porhomayon J, El-Solh AA.
Western New York Respiratory Research Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA.
Sleep Breath. 2012 Feb 29. [Epub ahead of print]
PURPOSE:
Clinical and epidemiologic investigations suggest a strong association between obesity and obstructive sleep apnea (OSA). The purpose of this study is to evaluate the currently available literature reporting on the effectiveness of dietary weight loss in treating OSA among obese patients.METHODS:
Relevant studies were identified by computerized searches of PubMed, EMBASE, CINAHL, Web of Science, and The Cochrane Central Register of Controlled Trials through September 2011 as well as the reference lists of all obtained articles. -
Socio-economic risk factors for incident restless legs syndrome in the general population
Szentkiralyi A, Fendrich K, Hoffmann W, Happe S, Berger K.
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary Institute for Community Medicine, University of Greifswald, Greifswald, Germany Centre for Integrated Dementia Care Research (CIDC), German Centre for Neurodegenerative Diseases (DZNE), Greifswald, Germany Department of Clinical Neurophysiology, Klinikum Bremen-Ost/University of Göttingen, Göttingen, Germany.
J Sleep Res. 2012 Feb 27. doi: 10.1111/j.1365-2869.2012.01001.x. [Epub ahead of print]
Abstract
Few and controversial data exist about the relationship between socio-economic status and restless legs syndrome, and prospective analyses are lacking. We aimed to explore the associations between socio-economic factors and incident restless legs syndrome in the general population. Two prospective population-based cohort studies were conducted: the Dortmund Health Study with a mean follow-up of 2.2 years; and the Study of Health in Pomerania with a mean follow-up of 5.2 years. The studies included 1312 subjects and 4308 subjects, respectively. Restless legs syndrome was assessed twice according to the standard minimal criteria. The modified Winkler Index of social class, education, job status, partnership and income were assessed by interviews at baseline. The risk of restless legs syndrome associated with each socio-economic factor was estimated by multivariable logistic regression adjusted for behavioural factors and co-morbidities. Female gender, being retired and unemployment were independent risk factors of incident restless legs syndrome in both studies. Low level of education and income were independently associated with incident restless legs syndrome only in the Dortmund Health Study, but not in the other study. Migrational background and shiftwork were further independent risk factors of restless legs syndrome that were only assessed in the Dortmund Health Study. People with less favourable socio-economic situation are at an increased risk of developing restless legs syndrome. Behavioural variables and co-morbidities did not explain this association, thus further studies are required to reveal the mechanism behind the proposed relationship.
Szentkiralyi A, Fendrich K, Hoffmann W, Happe S, Berger K.
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary Institute for Community Medicine, University of Greifswald, Greifswald, Germany Centre for Integrated Dementia Care Research (CIDC), German Centre for Neurodegenerative Diseases (DZNE), Greifswald, Germany Department of Clinical Neurophysiology, Klinikum Bremen-Ost/University of Göttingen, Göttingen, Germany.
J Sleep Res. 2012 Feb 27. doi: 10.1111/j.1365-2869.2012.01001.x. [Epub ahead of print]
Abstract
Few and controversial data exist about the relationship between socio-economic status and restless legs syndrome, and prospective analyses are lacking. We aimed to explore the associations between socio-economic factors and incident restless legs syndrome in the general population.
