San Francisco Coordinating Center, California Pacific Medical Center Research Institute, 185 Berry Street, Lobby 5, Suite 5700, San Francisco, CA 94107-1762, USA.
Arthritis Care Res (Hoboken). 2012 Jul;64(7):1070-8. doi: 10.1002/acr.21630.
To evaluate sleep quality in women with hip pain due to daily activities involving the lower extremity joints.
We evaluated the association of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) hip pain severity score with objective sleep measures obtained by wrist actigraphy in 2,225 white women ≥ 65 years of age enrolled in the Study of Osteoporotic Fractures.
Women had an increased odds of spending ≥ 90 minutes awake after sleep onset (odds ratio [OR] 1.28, 95% confidence interval [95% CI] 1.11-1.50) for every 5-point increase in hip pain score after adjustment for all covariates. Hip pain when sitting or lying was the strongest predictor of sleep fragmentation (OR 2.0, 95% CI 1.47-2.73); however, standing pain was associated with a higher number of awake minutes in bed scored from sleep onset to the end of the last sleep episode, independent of pain while in bed (OR 1.41, 95% CI 1.07-2.01). Sleep disturbances increased significantly after the first 2 hours of sleep in women with severe hip pain compared to those without hip pain (mean ± SD 1.4 ± 0.47 minutes per hour of sleep; P < 0.003). Similar associations were observed for long wake episodes >5 minutes. There were no associations between daytime napping, sleep latency, sleep efficiency, and total sleep minutes and WOMAC hip pain.
Fragmented sleep was greater in women with hip pain compared to those without hip pain; however, fragmented sleep in women with severe hip pain compared to those without hip pain was unchanged until after the first 2 hours of sleep. Further investigations into pain medications wearing off over time or the prolonged periods of inactivity decreasing the pain threshold are warranted.
评估因下肢关节日常活动导致髋痛的女性的睡眠质量。
我们评估了安大略省西部和麦克马斯特大学骨关节炎指数（WOMAC）髋痛严重程度评分与通过腕部活动记录仪获得的客观睡眠测量值之间的关联，该研究共纳入了 2225 名年龄≥65 岁的白人女性，这些女性参加了骨质疏松性骨折研究。
女性髋痛评分每增加 5 分，入睡后觉醒时间≥90 分钟的可能性就会增加（优势比 [OR] 1.28，95%置信区间 [95%CI] 1.11-1.50），调整所有协变量后结果仍然如此。坐卧时髋痛是睡眠碎片化的最强预测因素（OR 2.0，95%CI 1.47-2.73）；然而，站立时的疼痛与从入睡到最后一次睡眠结束时的床上清醒时间的增加有关，与床上疼痛无关（OR 1.41，95%CI 1.07-2.01）。与无髋痛女性相比，严重髋痛女性在入睡后前 2 小时的睡眠中，睡眠干扰显著增加（平均 ± 标准差 1.4 ± 0.47 分钟/小时的睡眠；P < 0.003）。对于 >5 分钟的长时间觉醒事件也观察到类似的关联。WOMAC 髋痛与日间小睡、睡眠潜伏期、睡眠效率和总睡眠时间之间无关联。
与无髋痛女性相比，髋痛女性的睡眠碎片化更严重；然而，与无髋痛女性相比，严重髋痛女性的睡眠碎片化直到入睡后前 2 小时才保持不变。需要进一步研究随着时间的推移止痛药物作用减弱或长时间不活动降低疼痛阈值的情况。
