title: Sleep impairment and insomnia in sickle cell disease: a retrospective chart review of clinical and psychological indicators.
abstract: OBJECTIVE
  To examine clinical and psychological indicators associated with sleeplessness and insomnia in adult patients with sickle cell.
  
  
  METHODS
  PubMed, Scopus, Cochrane Library. Data were collected from adult sickle cell participants (N = 72) in outpatient clinics at a Midwest National Cancer Institute designated comprehensive cancer center. A retrospective chart review observed for clinical and psychological indicators associated with sleeplessness and insomnia.
  
  
  CONCLUSIONS
  Findings included that adults with sickle cell experienced insomnia (47%) and sleep impairment (15%). Significant associations existed between pain and sleep impairment (p = .00), insomnia and pain (p = .00), morning hours of sleep (p = .00), and evening hours (p = .00). Pain may contribute to insomnia or interrupt sleep; daytime sleeping was not conducive to nighttime sleep. Anxiolytics, antidepressants, and long-acting opioids were not associated with insomnia (p = .00, p = .43, and p = .10), respectively; reduction in anxiety may reduce insomnia. Long-acting opioids may provide for improved pain control sleep.
  
  
  CONCLUSIONS
  Healthcare providers play a pivotal role in the assessment of sleep impairment or disorders. Effective management is necessary for improved quality of life. Further investigation is warranted to understand the meaning of sleep impairment in adult patients with sickle cell with prospective controlled studies to examine the efficacy of interventions.
authors.affiliation: Sickle Cell Clinics, James Cancer Hospital & Solove Research Institute, The Ohio State University, Columbus, Ohio.|College of Nursing, Capital University, Columbus, Ohio.
authors.forename: Valerie
authors.initials: V
authors.lastname: Mann-Jiles
authors.affiliation: James Cancer Hospital & Solove Research Institute, Columbus, Ohio.|College of Nursing, The Ohio State University, Columbus, Ohio.
authors.forename: Kathrynn
authors.initials: K
authors.lastname: Thompson
authors.affiliation: Department of Psychology, Comprehensive Cancer Clinic, The Ohio State University, Columbus, Ohio.|Division of Surgical Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: Joanne
authors.initials: J
authors.lastname: Lester
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D009820:Ohio; D010147:Pain Measurement; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000150:complications / Q000451:nursing / Q000523:psychology*; D055815:Young Adult
keywords: Sleep impairment; adults; insomnia; pain; sickle cell disease