School of Nursing, University of California, San Francisco, California, USA.
J Pain. 2011 Mar;12(3):390-400. doi: 10.1016/j.jpain.2010.09.008. Epub 2010 Dec 13.
To date, no studies have evaluated for differences in subjective and objective measures of sleep disturbance in oncology outpatients with and without pain. This descriptive study, recruited 182 patients from 2 radiation therapy (RT) departments at the time of the patient's simulation visit. Approximately 38% of the sample reported moderate to severe pain (ie, worst pain intensity of 6.2 ± 2.4). After controlling for age, patients in pain reported worse sleep quality and more sleep disturbance using the Pittsburgh Sleep Quality Index. With the General Sleep Disturbance Scale, patients in pain reported poorer sleep quality, increased use of sleep medications, and more daytime sleepiness. In addition using an objective measure of sleep disturbance (ie, actigraphy), significant gender × pain interactions were found for sleep onset latency, percentage of time awake at night, wake duration, total sleep time, and sleep efficiency. While no differences were found in female patients, males in pain had worse scores than males without pain. Findings from this study suggest that pain and sleep disturbance are prevalent in oncology outpatients and that a patient's age and gender need to be considered in any evaluation of the relationship between pain and sleep.
The effects of pain on subjective and objective sleep parameters appear to be influenced by both patients' age and gender.
迄今为止，尚无研究评估肿瘤门诊患者中有无疼痛者的睡眠障碍的主观和客观测量指标的差异。本描述性研究在患者模拟就诊时从 2 个放射治疗 (RT) 科招募了 182 名患者。约 38%的样本报告有中度至重度疼痛（即，最痛强度为 6.2±2.4）。在控制年龄后，疼痛患者使用匹兹堡睡眠质量指数报告睡眠质量更差，睡眠障碍更多。使用一般睡眠障碍量表，疼痛患者睡眠质量较差，使用睡眠药物更多，白天嗜睡更多。此外，使用睡眠障碍的客观测量指标（即活动记录仪），发现睡眠潜伏期、夜间清醒百分比、清醒时间、总睡眠时间和睡眠效率方面存在显著的性别×疼痛交互作用。虽然在女性患者中未发现差异，但疼痛男性的评分比无疼痛男性差。本研究结果表明，疼痛和睡眠障碍在肿瘤门诊患者中很常见，在评估疼痛与睡眠之间的关系时，需要考虑患者的年龄和性别。
疼痛对主观和客观睡眠参数的影响似乎同时受到患者年龄和性别的影响。
