1Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Yawkey Center, Massachusetts General Hospital, Boston, USA
2Department of Psychiatry, Massachusetts General Hospital, Boston, USA
Background: Although upper-extremity disability correlates with psychosocial aspects of illness the association with sleep disturbance in upper extremity disability is less certain. To evaluate whether sleep disturbance is associated with upper-extremity disability among patients with upper extremity illness, accounting for sociodemographic, condition-related, and psychosocial factors. Methods: A cohort of 111 new or follow-up patients presenting to an urban academic hospital-based hand surgeon completed a sociodemographic survey and measures of sleep disturbance (PROMIS Sleep Disturbance), disability (PROMIS Upper-Extremity Physical Function), ineffective coping strategies (PROMIS Pain Interference), and depression (PROMIS Depression). Bivariate and multivariable linear regression modeling were performed. Results: Sleep disturbance correlated with disability (r=-0.38; P<0.001) in bivariate analysis. Symptoms of depression (r=-0.44; P<0.001) and ineffective coping strategies (PROMIS Pain Interference: r=-0.71; P<0.001) also correlated with upper-extremity specific disability in bivariate analysis. Pain Interference was the only factor associated with disability in multivariable analysis. Conclusions: Sleep disturbance is not as strongly or directly associated with symptom intensity and magnitude of disability as ineffective coping strategies. Interventions to reduce pain interference (e.g. cognitive behavioral therapy) hold great potential to decrease musculoskeletal symptom intensity and magnitude of disability, and perhaps even sleep disturbance.
Ring D, Kadzielski J, Fabian L, Zurakowski D, Malhotra LR, Jupiter JB. Self-reported upper extremity health status correlates with depression. J Bone Joint Surg Am. 2006; 88(9):1983-8.
Lindenhovius AL, Buijze GA, Kloen P, Ring DC. Correspondence between perceived disability and objective physical impairment after elbow trauma. J Bone Joint Surg Am. 2008; 90(10):2090-7.
Menendez ME, Bot AG, Hageman MG, Neuhaus V, Mudgal CS, Ring D. Computerized adaptive testing of psychological factors: relation to upper-extremity disability. J Bone Joint Surg Am. 2013; 95(20):e149.
Bot AG, Doornberg JN, Lindenhovius AL, Ring D, Goslings JC, van Dijk CN. Long-term outcomes of fractures of both bones of the forearm. J Bone Joint Surg Am. 2011; 93(6):527-32.
Doornberg JN, Ring D, Fabian LM, Malhotra L, Zurakowski D, Jupiter JB. Pain dominates measurements of elbow function and health status. J Bone Joint Surg Am. 2005; 87(8):1725-31.
Das De S, Vranceanu AM, Ring DC. Contribution of kinesophobia and catastrophic thinking to upper-extremity-specific disability. J Bone Joint Surg Am. 2013; 95(1):76-81.
Patel JN, McCabe SJ, Myers J. Characteristics of sleep disturbance in patients with carpal tunnel syndrome. Hand (N Y). 2012; 7(1):55-8.
Patel A, Culbertson MD, Patel A, Hashem J, Jacob J, Edelstein D, et al. The negative effect of carpal tunnel syndrome on sleep quality. Sleep Disord. 2014; 2014(10):1-7.
Cho CH, Jung SW, Park JY, Song KS, Yu KI. Is shoulder pain for three months or longer correlated with depression, anxiety, and sleep disturbance? J Shoulder Elbow Surg. 2013; 22(2):222-8.
Shulman BS, Liporace FA, Davidovitch RI, Karia R, Egol KA. Sleep disturbance after fracture is related to emotional well-being rather than functional result. J Orthop Trauma. 2014; 29(3):e146-50.
Wilcox S, Brenes GA, Levine D, Sevick MA, Shumaker SA, Craven T. Factors related to sleep disturbance in older adults experiencing knee pain or knee pain with radiographic evidence of knee osteoarthritis. J Am Geriatr Soc. 2000; 48(10):1241-51.
Buysse DJ, Yu L, Moul DE, Germain A, Stover A, Dodds NE, et al. Development and validation of patient-reported outcome measures for sleep disturbance and sleep-related impairments. Sleep. 2010; 33(6):781-92.
Hays RD, Spritzer KL, Amtmann D, Lai JS, Dewitt EM, Rothrock N, et al. Upper-extremity and mobility subdomains from the Patient-Reported Outcomes Measurement Information System (PROMIS) adult physical functioning item bank. Arch Phys Med Rehabil. 2013; 94(11):2291-6.
Amtmann D, Cook KF, Jensen MP, Chen WH, Choi S, Revicki D, et al. Development of a PROMIS item bank to measure pain interference. Pain. 2010; 150(1):173-82.
Pilkonis PA, Choi SW, Reise SP, Stover AM, Riley WT, Cella D, et al. Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS®): depression, anxiety, and anger. Assessment. 2011; 18(3):263-83.
Chakravarty EF, Bjorner JB, Fries JF. Improving patient reported outcomes using item response theory and computerized adaptive testing. J Rheumatol. 2007; 34(6):1426-31.
Yu L, Buysse DJ, Germain A, Moul DE, Stover A, Dodds NE, et al. Development of short forms from the PROMISTM sleep disturbance and Sleep-Related Impairment item banks. Behav Sleep Med. 2011; 10(1):6-24.
Vranceanu AM, Barsky A, Ring D. Psychosocial aspects of disabling musculoskeletal pain. J Bone Joint Surg Am. 2009; 91(8):2014-8.
Owens J, Adolescent Sleep Working Group, Committee on Adolescence. Insufficient sleep in adolescents and young adults: an update on causes and consequences. Pediatrics. 2014; 134(3):e921-32.
Blumen MB, Quera Salva MA, Vaugier I, Leroux K, d’Ortho MP, Barbot F, et al. Is snoring intensity responsible for the sleep partner’s poor quality of sleep? Sleep Breath. 2012; 16(3):903-7.
Palhares Vde C, Corrente JE, Matsubara BB. Association between sleep quality and quality of life in nursing professionals working rotating shifts. Rev Saude Publica. 2014; 48(4):594-601.
Orbeta RL, Overpeck MD, Ramcharran D, Kogan MD, Ledsky R. High caffeine intake in adolescents: associations with difficulty sleeping and feeling tired in the morning. J Adolesc Health. 2006; 38(4):451-3.
Noland H, Price JH, Dake J, Telljohann SK. Adolescents’ sleep behaviors and perceptions of sleep. J Sch Health. 2009; 79(5):224-30.
Overbeek CL, Nota SP, Jayakumar P, Hageman MG, Ring D. The PROMIS physical function correlates with the QuickDASH in patients with upper extremity illness. Clin Orthop Relat Res. 2015; 473(1):311-7.
Vranceanu AM, Hageman M, Strooker J, Ter Meulen D, Vrahas M, Ring D. A preliminary RCT of a mind body skills based intervention addressing mood and coping strategies in patients with acute orthopaedic trauma. Injury. 2014; 46(4):552-7.