Sequential daily relations of sleep, pain intensity, and attention to pain among women with fibromyalgia

Abstract

Fifty women with fibromyalgia syndrome (FS) recorded their sleep quality, pain intensity, and attention to pain for 30 days, using palm-top computers programmed as electronic interviewers. They described their previous night's sleep quality within one-half hour of awakening each day, and at randomly selected times in the morning, afternoon, and evening rated their present pain in 14 regions and attention to pain during the last 30 min. We analyzed the 30-day aggregates cross-sectionally at the across-persons level and the pooled data set of 1500 person-days at the within-persons level after adjusting for between-persons variation and autocorrelation. Poorer sleepers tended to report significantly more pain. A night of poorer sleep was followed by a significantly more painful day, and a more painful day was followed by a night of poorer sleep. Pain attention and sleep were unrelated at the across-persons level of analysis. But there was a significant bi-directional within-person association between pain attention and sleep quality that was not explained by changes in pain intensity.

Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain

“…Is it even so that poor sleep quality can enhance or even result in pain if persisting for a longer period of time? In a study on pain and sleep in women with fibromyalgia, 32 the authors suggest that poor sleep precedes increased pain, rather than the opposite. On the other hand, in a study in patients with chronic pain conditions, other researchers reported that the onset of sleep disturbances coincided or followed the onset of pain, 13 which suggests that sleep disturbances are secondary to pain.…”

Sleep disturbance in fibromyalgia syndrome

“…For some, poor sleep becomes a central issue in the course of FMS and poor sleep is inextricably linked with the experience of pain [7,8,9,10]. This association appears to be bi-directional with poor sleep linked to increased reporting of pain, and increased pain linked to poor sleep [8].…”

“…This association appears to be bi-directional with poor sleep linked to increased reporting of pain, and increased pain linked to poor sleep [8]. Another common complaint is depression [11,12], although less is known about the interaction/s between sleep depression, fatigue, wellbeing and physical functioning in FMS.…”

“…An important, yet unresolved issue in the pain literature is whether sleep precedes/predicts pain, or whether pain precedes/predicts sleep quality [8,17,18,19,20,21]. The temporal sequence of pain and sleep presents an interesting challenge clinically, yet there has only been a small number of studies investigating this issue, and the question of directionality remains unanswered.…”

“…The temporal sequence of pain and sleep presents an interesting challenge clinically, yet there has only been a small number of studies investigating this issue, and the question of directionality remains unanswered. For example, Affleck et al, [8] investigated the association between sleep quality and pain intensity and attention to pain over 30 consecutive days in 50 women with fibromyalgia syndrome. Sleep and pain showed bi-directional correlations, poor sleep was associated with a more painful day, and a more painful day was followed by a poor Potentially there are many different reasons why patients with FMS experience poor sleep.…”