Landis Carol A, Frey Christine A, Lentz Martha J, Rothermel James, Buchwald Dedra, Shaver Joan L F
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, 98195-7266, USA.
Nurs Res. 2003 May-Jun;52(3):140-7. doi: 10.1097/00006199-200305000-00002.
Limited data are available on the relationship between self-reported sleep quality, fatigue, and behavioral sleep patterns in women with fibromyalgia (FM).
To compare self-reported sleep quality, fatigue, and behavioral sleep indicators obtained by actigraphy between women with FM and sedentary women without pain, and to examine relationships among these variables.
Twenty-three women with FM (M = 47.3, +/- 6.7 years) and 22 control women (M = 43.5, +/- 8.2 years) wore an actigraph on the nondominant wrist for 3 consecutive days at home. Each day women reported bedtimes, rise times, and ratings of sleep quality and fatigue in a diary. Self-reported sleep quality, fatigue, and indicators of sleep quality obtained from actigraphy (e.g., total sleep time, sleep efficiency, sleep latency, wake after sleep onset, and fragmentation index) were averaged. The Mann Whitney U test was used to assess group differences. Pearson Product Moment Correlation was used to evaluate relationships between sleep quality and fatigue, and among sleep quality, fatigue, and actigraphy sleep indicators.
Women with FM reported poorer sleep quality and more fatigue compared to controls (both p <.001). Actigraphy sleep indicators were not different between groups. In women with FM but not in controls, self-reported sleep quality was directly related to actigraphy indicators of total sleep time (r =.635, p <.01) and inversely related to sleep fragmentation (r = -.46, p <.05). Fatigue in women with FM was directly related to actigraphy indicators of wake after sleep onset (r =.57, p <.01), and inversely related to sleep efficiency (r = -.545, p <.01).
Self-reported sleep quality and fatigue are associated with behavioral indicators of sleep quality at home in women with FM. Actigraphy is a useful objective measure of improved sleep outcomes in intervention studies.
关于纤维肌痛（FM）女性自我报告的睡眠质量、疲劳与行为睡眠模式之间关系的数据有限。
比较FM女性与无疼痛的久坐女性自我报告的睡眠质量、疲劳以及通过活动记录仪获得的行为睡眠指标，并研究这些变量之间的关系。
23名FM女性（平均年龄47.3±6.7岁）和22名对照女性（平均年龄43.5±8.2岁）在家中 nondominant 手腕上连续佩戴活动记录仪3天。每天女性在日记中记录就寝时间、起床时间以及睡眠质量和疲劳程度评分。对自我报告的睡眠质量、疲劳以及从活动记录仪获得的睡眠质量指标（如总睡眠时间、睡眠效率、睡眠潜伏期、睡眠中觉醒和碎片化指数）进行平均。采用曼-惠特尼U检验评估组间差异。使用皮尔逊积差相关来评估睡眠质量与疲劳之间以及睡眠质量、疲劳与活动记录仪睡眠指标之间的关系。
与对照组相比，FM女性报告的睡眠质量较差且疲劳程度更高（均p<.001）。两组间活动记录仪睡眠指标无差异。在FM女性中，而非对照组中，自我报告的睡眠质量与总睡眠时间的活动记录仪指标直接相关（r =.635，p<.01），与睡眠碎片化呈负相关（r = -.46，p<.05）。FM女性的疲劳与睡眠中觉醒的活动记录仪指标直接相关（r =.57，p<.01），与睡眠效率呈负相关（r = -.545，p<.01）。
在FM女性中，自我报告的睡眠质量和疲劳与家中睡眠质量的行为指标相关。活动记录仪是干预研究中改善睡眠结果的有用客观测量方法。
