Daily variations in objective nighttime sleep and subjective morning pain in older adults with insomnia: evidence of covariation over time.
OBJECTIVE
To examine the relationship between objectively measured nocturnal sleep and subjective report of morning pain in older adults with insomnia; to examine not only the difference between persons in the association between sleep and pain (mean level over 14 days), but also the within-person, day-to-day association.


METHODS
Cross-sectional.


METHODS
North-central Florida.


METHODS
Fifty community-dwelling older adults (mean age+/-standard deviation 69.1+/-7.0, range 60-90) with insomnia.


METHODS
Daily home-based assessment using nightly actigraphic measurement of sleep and daily self-report of pain over 14 consecutive days.


RESULTS
Between persons, average sleep over 14 days was not associated with average levels of rated pain, but after a night in which an older adult with insomnia experienced above-average total sleep time he or she subsequently reported below-average pain ratings. The model explained approximately 24% of the within-person and 8% of the between-person variance in pain ratings.


CONCLUSIONS
Sleep and pain show day-to-day associations (i.e., covary over time) in older adults with insomnia. Such associations may suggest that common physiological systems underlie the experience of insomnia and pain. Future research should examine the crossover effects of sleep treatment on pain and of pain treatment on sleep.
Dzierzewski
Joseph M
JM
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida 32610, USA.
Williams
Jacob M
JM
Roditi
Daniela
D
Marsiske
Michael
M
McCoy
Karin
K
McNamara
Joseph
J
Dautovich
Natalie
N
Robinson
Michael E
ME
McCrae
Christina S
CS
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007206:Individuality; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000503:physiopathology*; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000503:physiopathology*
J Psychiatr Res. 1975 Nov;12(3):189-98
1202204
J Pain. 2009 Apr;10(4):343-53
19327641
Sleep Med Clin. 2009 Dec 1;4(4):593-604
23390408
J Pain. 2008 Feb;9(2):105-21
18055266
Pain Med. 2005 Sep-Oct;6(5):336-45
16266354
Sleep Med Rev. 2000 Jun;4(3):277-298
12531170
Int J Behav Med. 2008;15(3):201-10
18696314
Pain. 1996 Dec;68(2-3):363-8
9121825
J Psychiatr Res. 1982-1983;17(1):37-49
7183759
Sleep. 2007 Jul;30(7):873-80
17682658
Pain. 1999 Mar;80(1-2):1-13
10204712
J Nerv Ment Dis. 1993 Jun;181(6):377-81
8501459
Pain. 1993 Nov;55(2):195-203
8309709
Sleep. 1991 Feb;14(1):13-7
1811313
Pain. 1998 Feb;74(2-3):181-7
9520232
J Clin Sleep Med. 2009 Aug 15;5(4):355-62
19968014
Aging Ment Health. 2006 Mar;10(2):177-81
16517493
J Sleep Res. 2001 Mar;10(1):35-42
11285053
J Am Geriatr Soc. 1991 Feb;39(2):149-55
1991947
Prog Neurobiol. 2009 Feb;87(2):81-97
18952143
J Sleep Res. 2008 Mar;17(1):42-53
18275554
Pain. 2004 Jul;110(1-2):130-9
15275760
Sleep. 2006 Feb;29(2):142-3
16494080
Psychol Aging. 2007 Mar;22(1):18-27
17385979
J Gerontol B Psychol Sci Soc Sci. 2005 Jul;60(4):P182-9
15980285