title: Acute Pain and Depressive Symptoms: Independent Predictors of Insomnia Symptoms among Adults with Sickle Cell Disease.
abstract: No studies to date have systematically investigated insomnia symptoms among adults with sickle cell disease (SCD). The purpose of this study was to (1) describe the prevalence of insomnia symptoms and (2) identify biopsychosocial predictors in community-dwelling adults with SCD. Cross-sectional analysis of baseline data from 263 African American adults with SCD (aged 18 years or older). Measures included the Insomnia Severity Index (ISI), Center for Epidemiologic Studies in Depression scale, Urban Life Stress Scale, Brief Pain Inventory, and a chronic pain item. SCD genotype was extracted from the medical record. A slight majority (55%) of the sample reported clinically significant insomnia symptomatology (ISI ≥ 10), which suggests that insomnia symptoms are prevalent among community-dwelling African American adults with SCD. While insomnia symptoms were associated with a number of biopsychosocial characteristics, depressive symptoms and acute pain were the only independent predictors. Given the high number of participants reporting clinically significant insomnia symptoms, nurses should screen for insomnia symptoms and explore interventions to promote better sleep among adults with SCD, with an emphasis on recommending treatment for pain and depression. In addition, current pain and depression interventions in this population could add insomnia measures and assess the effect of the intervention on insomnia symptomatology as a secondary outcome.
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD. Electronic address: gmoscou1@jhu.edu.
authors.forename: Gyasi
authors.initials: G
authors.lastname: Moscou-Jackson
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD.
authors.forename: Jerilyn
authors.initials: J
authors.lastname: Allen
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kozachik
authors.affiliation: Johns Hopkins Center for Behavior and Health, Baltimore, MD.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Smith
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD.
authors.forename: Chakra
authors.initials: C
authors.lastname: Budhathoki
authors.affiliation: Johns Hopkins Berman Institute of Bioethics, Baltimore, MD.
authors.forename: Carlton
authors.initials: C
authors.lastname: Haywood
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D000755:Anemia, Sickle Cell / Q000150:complications*; D059350:Chronic Pain / Q000209:etiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology*