title: The effects of pain, gender, and age on sleep/wake and circadian rhythm parameters in oncology patients at the initiation of radiation therapy.
abstract: 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.
  
  
  CONCLUSIONS
  The effects of pain on subjective and objective sleep parameters appear to be influenced by both patients' age and gender.
authors.affiliation: School of Nursing, University of California, San Francisco, California, USA.
authors.forename: David
authors.initials: D
authors.lastname: Buffum
authors.forename: Theresa
authors.initials: T
authors.lastname: Koetters
authors.forename: Maria
authors.initials: M
authors.lastname: Cho
authors.forename: Liz
authors.initials: L
authors.lastname: Macera
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.forename: Claudia
authors.initials: C
authors.lastname: West
authors.forename: Bradley
authors.initials: B
authors.lastname: Aouizerat
authors.forename: Laura
authors.initials: L
authors.lastname: Dunn
authors.forename: Marylin
authors.initials: M
authors.lastname: Dodd
authors.forename: Kathryn
authors.initials: K
authors.lastname: Lee
authors.forename: Bruce
authors.initials: B
authors.lastname: Cooper
authors.forename: William
authors.initials: W
authors.lastname: Wara
authors.forename: Patrick
authors.initials: P
authors.lastname: Swift
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
mesh_terms: D056044:Actigraphy / Q000379:methods; D000368:Aged; D002940:Circadian Rhythm / Q000502:physiology* / Q000528:radiation effects; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000532:radiotherapy; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D017286:Polysomnography; D012727:Sex Characteristics; D012893:Sleep Wake Disorders / Q000209:etiology*; D014851:Wakefulness / Q000502:physiology* / Q000528:radiation effects