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Associations between pain, objective sleep efficiency and cognition in patients with implantable cardioverter defibrillators.
Sleep Med. 2020 Apr 06; 72:122-125.SM

Abstract

INTRODUCTION

Patients with implantable cardioverter defibrillators (ICDs) frequently experience sleep disruption. Prior work shows associations between objective (actigraphic) sleep and cognition in these patients, but whether pain affects associations between measures of sleep fragmentation (eg, sleep efficiency, SE) and cognition is unknown. The present study examined independent and interactive associations between objective SE and pain on cognitive performance in patients with ICDs.

METHODS

A total of 37 patients with ICDs (Mage = 60.0, SD = 12.4) and self-reported sleep disturbance completed 14 days of actigraphy. Average SE was computed [(average total sleep time/average time in bed) × 100%]. Patients completed the Short Form 36 Health Survey pain section, and computerized tasks measuring executive functioning (letter series, N-Back task), sustained attention/processing speed (symbol digit modalities test, SDMT), and simple reaction time. Multiple linear regressions examined whether SE independently predicted or interacted with pain ratings to predict cognitive performance.

RESULTS

SE interacted with pain to predict SDMT performance, accounting for 12% unique variance. In patients reporting worse pain, higher SE was associated with better SDMT performance. Similar patterns of association on SDMT were not observed in patients with average or low pain. SE and pain ratings did not independently predict SDMT performance. Performance on other cognitive tasks was not associated with any predictors.

CONCLUSION

Better sleep efficiency may play an important role in improving sustained attention/processing speed in patients with ICDs and perceived severe pain. Future research should examine whether interventions aimed at improving sleep fragmentation provide benefit to lower order cognition, particularly in patients with worse pain.

Authors+Show Affiliations

Department of Psychiatry, University of Missouri, Columbia, MO, USA; Department of Psychological Sciences, University of Missouri, Columbia, MO, USA.Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, OH, USA.Department of Psychology, East Carolina University, Greenville, NC, USA; Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA.Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA.College of Medicine, University of Florida, Gainesville, FL, USA.Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.Department of Psychiatry, University of Missouri, Columbia, MO, USA. Electronic address: mccraec@health.missouri.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32615460

Citation

Curtis, Ashley F., et al. "Associations Between Pain, Objective Sleep Efficiency and Cognition in Patients With Implantable Cardioverter Defibrillators." Sleep Medicine, vol. 72, 2020, pp. 122-125.
Curtis AF, Roth AJ, Sears SF, et al. Associations between pain, objective sleep efficiency and cognition in patients with implantable cardioverter defibrillators. Sleep Med. 2020;72:122-125.
Curtis, A. F., Roth, A. J., Sears, S. F., Conti, J. B., Berry, R. B., Dzierzewski, J. M., & McCrae, C. S. (2020). Associations between pain, objective sleep efficiency and cognition in patients with implantable cardioverter defibrillators. Sleep Medicine, 72, 122-125. https://doi.org/10.1016/j.sleep.2020.03.029
Curtis AF, et al. Associations Between Pain, Objective Sleep Efficiency and Cognition in Patients With Implantable Cardioverter Defibrillators. Sleep Med. 2020 Apr 6;72:122-125. PubMed PMID: 32615460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations between pain, objective sleep efficiency and cognition in patients with implantable cardioverter defibrillators. AU - Curtis,Ashley F, AU - Roth,Alicia J, AU - Sears,Samuel F, AU - Conti,Jamie B, AU - Berry,Richard B, AU - Dzierzewski,Joseph M, AU - McCrae,Christina S, Y1 - 2020/04/06/ PY - 2019/08/10/received PY - 2020/01/02/revised PY - 2020/03/28/accepted PY - 2020/7/3/pubmed PY - 2020/7/3/medline PY - 2020/7/3/entrez KW - Cognition KW - Implantable cardioverter defibrillators KW - Insomnia KW - Pain KW - Sleep efficiency SP - 122 EP - 125 JF - Sleep medicine JO - Sleep Med. VL - 72 N2 - INTRODUCTION: Patients with implantable cardioverter defibrillators (ICDs) frequently experience sleep disruption. Prior work shows associations between objective (actigraphic) sleep and cognition in these patients, but whether pain affects associations between measures of sleep fragmentation (eg, sleep efficiency, SE) and cognition is unknown. The present study examined independent and interactive associations between objective SE and pain on cognitive performance in patients with ICDs. METHODS: A total of 37 patients with ICDs (Mage = 60.0, SD = 12.4) and self-reported sleep disturbance completed 14 days of actigraphy. Average SE was computed [(average total sleep time/average time in bed) × 100%]. Patients completed the Short Form 36 Health Survey pain section, and computerized tasks measuring executive functioning (letter series, N-Back task), sustained attention/processing speed (symbol digit modalities test, SDMT), and simple reaction time. Multiple linear regressions examined whether SE independently predicted or interacted with pain ratings to predict cognitive performance. RESULTS: SE interacted with pain to predict SDMT performance, accounting for 12% unique variance. In patients reporting worse pain, higher SE was associated with better SDMT performance. Similar patterns of association on SDMT were not observed in patients with average or low pain. SE and pain ratings did not independently predict SDMT performance. Performance on other cognitive tasks was not associated with any predictors. CONCLUSION: Better sleep efficiency may play an important role in improving sustained attention/processing speed in patients with ICDs and perceived severe pain. Future research should examine whether interventions aimed at improving sleep fragmentation provide benefit to lower order cognition, particularly in patients with worse pain. SN - 1878-5506 UR - https://www.unboundmedicine.com/medline/citation/32615460/Associations_between_pain,_objective_sleep_efficiency_and_cognition_in_patients_with_implantable_cardioverter_defibrillators L2 - https://linkinghub.elsevier.com/retrieve/pii/S1389-9457(20)30150-7 DB - PRIME DP - Unbound Medicine ER -
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