title: An actigraphy study of sleep and pain in midlife women: the Study of Women's Health Across the Nation Sleep Study.
abstract: OBJECTIVE
  We examined whether women reporting nighttime pain would have more actigraphy-measured evidence for disturbed sleep and would report feeling less rested compared with women without nighttime pain.
  
  
  METHODS
  Up to 27 consecutive nights of actigraphy and sleep diary data from each participant were analyzed in this community-based study of 314 African-American (n = 118), white (n = 141), and Chinese (n = 55) women, aged 48 to 58 years, who were premenopausal, perimenopausal, or postmenopausal and were participating in the Study of Women's Health Across the Nation Sleep Study. Dependent variables were actigraphy-measured movement and fragmentation index, total sleep time, sleep efficiency, and diary self-report of "feeling rested" after waking up. All outcomes were fitted using linear mixed-effects models to examine covariate-adjusted associations between the independent variable (nighttime pain severity) and sleep outcomes.
  
  
  RESULTS
  Higher pain severity scores were associated with longer sleep duration but reduced sleep efficiency and less restful sleep. Women reporting nocturnal vasomotor symptoms had more sleep-related movement and sleep fragmentation, had reduced sleep efficiency, and were less likely to feel rested after wakening whether or not they reported pain.
  
  
  CONCLUSIONS
  Midlife women who report higher nighttime pain levels have more objective evidence for less efficient sleep, consistent with self-reported less restful sleep. Nocturnal vasomotor symptoms also can contribute to restlessness and wakefulness in midlife women.
authors.affiliation: From the 1Department of Psychiatry, Rush University Medical Center, Chicago, IL; 2Department of Preventive Medicine, Rush University Medical Center, Chicago, IL; 3Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI; 4Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; and 5Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Howard M
authors.initials: HM
authors.lastname: Kravitz
authors.forename: Huiyong
authors.initials: H
authors.lastname: Zheng
authors.forename: Joyce T
authors.initials: JT
authors.lastname: Bromberger
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Buysse
authors.forename: Jane
authors.initials: J
authors.lastname: Owens
authors.forename: Martica H
authors.initials: MH
authors.lastname: Hall
mesh_terms: D056044:Actigraphy; D001741:Black or African American; D001213:Asian; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D009068:Movement; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement / Q000379:methods*; D017286:Polysomnography; D057566:Self Report; D012890:Sleep; D012893:Sleep Wake Disorders / Q000209:etiology / Q000503:physiopathology; D014481:United States; D044465:White People; D016387:Women's Health