Sleep disturbance, depression and pain in adults with sickle cell disease

Gwenyth R. Wallen, Caterina P. Minniti, Michael Krumlauf, Ellen Eckes, Darlene Allen, Anna Oguhebe, Cassie Seamon, Deepika S. Darbari, Mariana Hildesheim, Li Yang, Jeffrey D. Schulden, Gregory J. Kato, James G. Taylor VI

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Sleep disturbance and depression are commonly encountered in primary care. In sickle cell disease, depression is associated with pain, poor treatment compliance, and lower quality of life. The prevalence of sleep disturbance and its effect upon quality of life in adults with sickle cell disease is unknown. The goal of this study was to determine the prevalence of sleep disturbance and if it is associated with pain and depression in sickle cell disease.Methods: Three hundred twenty eight adults with sickle cell disease enrolled on the Bethesda Sickle Cell Cohort Study were assessed using the Pittsburgh Sleep Quality Index and Beck Depression Inventory II screening measures as a cross-sectional survey. Scores greater than 5 (Pittsburgh Sleep Quality Index) and 16 (Beck Depression Inventory II) defined sleep disturbance and depression, respectively. Clinical and laboratory parameters were also assessed.Results: The mean Pittsburgh Sleep Quality Index score was 8.4 (SD ± 4.2) indicating a 71.2% prevalence of sleep disturbance. The mean Beck Depression Inventory II score was 8.0 (SD ± 8.9). Sixty five (20.6%) participants had a score indicating depression, and half of these (10.0%) had thoughts of suicide. Both Pittsburgh Sleep Quality Index and Beck Depression Inventory II scores were significantly correlated (p < .001). The number of days with mild/moderate pain (p = .001) and a history of headaches (p = .005) were independently associated with depression by multivariate regression analysis. Patients with sleep disturbance were older (p = .002), had higher body mass index (p = .011), had more days of pain (p = .003) and more frequent severe acute painful events (emergency room visits and hospitalizations) during the previous 12 months (p < .001).Conclusions: More than 70 percent of adults with sickle cell disease had sleep disturbance, while 21 percent showed evidence of clinical depression. Sleep disturbance and depression were correlated, and were most common among those with more frequent pain. Providers caring for adults with sickle cell disease and frequent pain should consider screening for these common co-morbidities. Additional study is needed to confirm these findings and to determine if treatments for pain, depression or sleep disturbances will improve quality of life measures in this patient population.Trial registration: ClinicalTrials.gov identifier: NCT00011648.

Original languageEnglish (US)
Article number207
JournalBMC Psychiatry
Volume14
Issue number1
DOIs
StatePublished - Jul 21 2014
Externally publishedYes

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Sickle Cell Anemia
Sleep
Depression
Pain
Equipment and Supplies
Quality of Life
Suicide
Headache
Hospital Emergency Service
Primary Health Care
Hospitalization
Body Mass Index
Cohort Studies
Multivariate Analysis
Cross-Sectional Studies
Regression Analysis

Keywords

  • Bethesda sickle cell cohort study
  • Chronic pain
  • Depression
  • Patient reported outcomes
  • Sickle cell disease
  • Sleep disturbance

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Medicine(all)

Cite this

Wallen, G. R., Minniti, C. P., Krumlauf, M., Eckes, E., Allen, D., Oguhebe, A., ... Taylor VI, J. G. (2014). Sleep disturbance, depression and pain in adults with sickle cell disease. BMC Psychiatry, 14(1), [207]. https://doi.org/10.1186/1471-244X-14-207

Sleep disturbance, depression and pain in adults with sickle cell disease. / Wallen, Gwenyth R.; Minniti, Caterina P.; Krumlauf, Michael; Eckes, Ellen; Allen, Darlene; Oguhebe, Anna; Seamon, Cassie; Darbari, Deepika S.; Hildesheim, Mariana; Yang, Li; Schulden, Jeffrey D.; Kato, Gregory J.; Taylor VI, James G.

In: BMC Psychiatry, Vol. 14, No. 1, 207, 21.07.2014.

Research output: Contribution to journalArticle

Wallen, GR, Minniti, CP, Krumlauf, M, Eckes, E, Allen, D, Oguhebe, A, Seamon, C, Darbari, DS, Hildesheim, M, Yang, L, Schulden, JD, Kato, GJ & Taylor VI, JG 2014, 'Sleep disturbance, depression and pain in adults with sickle cell disease', BMC Psychiatry, vol. 14, no. 1, 207. https://doi.org/10.1186/1471-244X-14-207
Wallen, Gwenyth R. ; Minniti, Caterina P. ; Krumlauf, Michael ; Eckes, Ellen ; Allen, Darlene ; Oguhebe, Anna ; Seamon, Cassie ; Darbari, Deepika S. ; Hildesheim, Mariana ; Yang, Li ; Schulden, Jeffrey D. ; Kato, Gregory J. ; Taylor VI, James G. / Sleep disturbance, depression and pain in adults with sickle cell disease. In: BMC Psychiatry. 2014 ; Vol. 14, No. 1.
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abstract = "Background: Sleep disturbance and depression are commonly encountered in primary care. In sickle cell disease, depression is associated with pain, poor treatment compliance, and lower quality of life. The prevalence of sleep disturbance and its effect upon quality of life in adults with sickle cell disease is unknown. The goal of this study was to determine the prevalence of sleep disturbance and if it is associated with pain and depression in sickle cell disease.Methods: Three hundred twenty eight adults with sickle cell disease enrolled on the Bethesda Sickle Cell Cohort Study were assessed using the Pittsburgh Sleep Quality Index and Beck Depression Inventory II screening measures as a cross-sectional survey. Scores greater than 5 (Pittsburgh Sleep Quality Index) and 16 (Beck Depression Inventory II) defined sleep disturbance and depression, respectively. Clinical and laboratory parameters were also assessed.Results: The mean Pittsburgh Sleep Quality Index score was 8.4 (SD ± 4.2) indicating a 71.2{\%} prevalence of sleep disturbance. The mean Beck Depression Inventory II score was 8.0 (SD ± 8.9). Sixty five (20.6{\%}) participants had a score indicating depression, and half of these (10.0{\%}) had thoughts of suicide. Both Pittsburgh Sleep Quality Index and Beck Depression Inventory II scores were significantly correlated (p < .001). The number of days with mild/moderate pain (p = .001) and a history of headaches (p = .005) were independently associated with depression by multivariate regression analysis. Patients with sleep disturbance were older (p = .002), had higher body mass index (p = .011), had more days of pain (p = .003) and more frequent severe acute painful events (emergency room visits and hospitalizations) during the previous 12 months (p < .001).Conclusions: More than 70 percent of adults with sickle cell disease had sleep disturbance, while 21 percent showed evidence of clinical depression. Sleep disturbance and depression were correlated, and were most common among those with more frequent pain. Providers caring for adults with sickle cell disease and frequent pain should consider screening for these common co-morbidities. Additional study is needed to confirm these findings and to determine if treatments for pain, depression or sleep disturbances will improve quality of life measures in this patient population.Trial registration: ClinicalTrials.gov identifier: NCT00011648.",
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AU - Wallen, Gwenyth R.

AU - Minniti, Caterina P.

AU - Krumlauf, Michael

AU - Eckes, Ellen

AU - Allen, Darlene

AU - Oguhebe, Anna

AU - Seamon, Cassie

AU - Darbari, Deepika S.

AU - Hildesheim, Mariana

AU - Yang, Li

AU - Schulden, Jeffrey D.

AU - Kato, Gregory J.

AU - Taylor VI, James G.

PY - 2014/7/21

Y1 - 2014/7/21

N2 - Background: Sleep disturbance and depression are commonly encountered in primary care. In sickle cell disease, depression is associated with pain, poor treatment compliance, and lower quality of life. The prevalence of sleep disturbance and its effect upon quality of life in adults with sickle cell disease is unknown. The goal of this study was to determine the prevalence of sleep disturbance and if it is associated with pain and depression in sickle cell disease.Methods: Three hundred twenty eight adults with sickle cell disease enrolled on the Bethesda Sickle Cell Cohort Study were assessed using the Pittsburgh Sleep Quality Index and Beck Depression Inventory II screening measures as a cross-sectional survey. Scores greater than 5 (Pittsburgh Sleep Quality Index) and 16 (Beck Depression Inventory II) defined sleep disturbance and depression, respectively. Clinical and laboratory parameters were also assessed.Results: The mean Pittsburgh Sleep Quality Index score was 8.4 (SD ± 4.2) indicating a 71.2% prevalence of sleep disturbance. The mean Beck Depression Inventory II score was 8.0 (SD ± 8.9). Sixty five (20.6%) participants had a score indicating depression, and half of these (10.0%) had thoughts of suicide. Both Pittsburgh Sleep Quality Index and Beck Depression Inventory II scores were significantly correlated (p < .001). The number of days with mild/moderate pain (p = .001) and a history of headaches (p = .005) were independently associated with depression by multivariate regression analysis. Patients with sleep disturbance were older (p = .002), had higher body mass index (p = .011), had more days of pain (p = .003) and more frequent severe acute painful events (emergency room visits and hospitalizations) during the previous 12 months (p < .001).Conclusions: More than 70 percent of adults with sickle cell disease had sleep disturbance, while 21 percent showed evidence of clinical depression. Sleep disturbance and depression were correlated, and were most common among those with more frequent pain. Providers caring for adults with sickle cell disease and frequent pain should consider screening for these common co-morbidities. Additional study is needed to confirm these findings and to determine if treatments for pain, depression or sleep disturbances will improve quality of life measures in this patient population.Trial registration: ClinicalTrials.gov identifier: NCT00011648.

AB - Background: Sleep disturbance and depression are commonly encountered in primary care. In sickle cell disease, depression is associated with pain, poor treatment compliance, and lower quality of life. The prevalence of sleep disturbance and its effect upon quality of life in adults with sickle cell disease is unknown. The goal of this study was to determine the prevalence of sleep disturbance and if it is associated with pain and depression in sickle cell disease.Methods: Three hundred twenty eight adults with sickle cell disease enrolled on the Bethesda Sickle Cell Cohort Study were assessed using the Pittsburgh Sleep Quality Index and Beck Depression Inventory II screening measures as a cross-sectional survey. Scores greater than 5 (Pittsburgh Sleep Quality Index) and 16 (Beck Depression Inventory II) defined sleep disturbance and depression, respectively. Clinical and laboratory parameters were also assessed.Results: The mean Pittsburgh Sleep Quality Index score was 8.4 (SD ± 4.2) indicating a 71.2% prevalence of sleep disturbance. The mean Beck Depression Inventory II score was 8.0 (SD ± 8.9). Sixty five (20.6%) participants had a score indicating depression, and half of these (10.0%) had thoughts of suicide. Both Pittsburgh Sleep Quality Index and Beck Depression Inventory II scores were significantly correlated (p < .001). The number of days with mild/moderate pain (p = .001) and a history of headaches (p = .005) were independently associated with depression by multivariate regression analysis. Patients with sleep disturbance were older (p = .002), had higher body mass index (p = .011), had more days of pain (p = .003) and more frequent severe acute painful events (emergency room visits and hospitalizations) during the previous 12 months (p < .001).Conclusions: More than 70 percent of adults with sickle cell disease had sleep disturbance, while 21 percent showed evidence of clinical depression. Sleep disturbance and depression were correlated, and were most common among those with more frequent pain. Providers caring for adults with sickle cell disease and frequent pain should consider screening for these common co-morbidities. Additional study is needed to confirm these findings and to determine if treatments for pain, depression or sleep disturbances will improve quality of life measures in this patient population.Trial registration: ClinicalTrials.gov identifier: NCT00011648.

KW - Bethesda sickle cell cohort study

KW - Chronic pain

KW - Depression

KW - Patient reported outcomes

KW - Sickle cell disease

KW - Sleep disturbance

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