title: Self-reported sleep quality and fatigue correlates with actigraphy in midlife women with fibromyalgia.
abstract: BACKGROUND
  Limited data are available on the relationship between self-reported sleep quality, fatigue, and behavioral sleep patterns in women with fibromyalgia (FM).
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, 98195-7266, USA. calandis@u.washington.edu
authors.forename: Carol A
authors.initials: CA
authors.lastname: Landis
authors.forename: Christine A
authors.initials: CA
authors.lastname: Frey
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Lentz
authors.forename: James
authors.initials: J
authors.lastname: Rothermel
authors.forename: Dedra
authors.initials: D
authors.lastname: Buchwald
authors.forename: Joan L F
authors.initials: JL
authors.lastname: Shaver
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001132:Arm / Q000503:physiopathology*; D016022:Case-Control Studies; D005221:Fatigue / Q000209:etiology*; D005260:Female; D005356:Fibromyalgia / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D009068:Movement; D017286:Polysomnography / Q000379:methods* / Q000592:standards; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014851:Wakefulness; D016387:Women's Health