TABLE 3-5Selected Sleep-Related Symptoms and Findings in the Presence of Pain

Bedtime symptoms
  • Delay in sleep onset
  • Anxiety, rumination
  • Intense fatigue and more intense pain
Sleep time findings
  • Lower sleep efficacy (less than 90%)
  • Longer percentage sleep time in stage 1, with less in stages 3 and 4
  • Numerous sleep stage shifts (stages 3 and 4 toward stages 2 or 1)
  • Fragmentation of sleep continuity (increase in number of microarousals, awakenings, sleep stage shifts, respiratory events, movement intrusions)
  • Alpha electroencephalographic intrusions in stages 3 and 4 with or without elevated phasic arousals (cyclic alternating pattern)
  • Absence of reduction in heart rate variability in sleep (cardiac sympathetic overactivation)
  • Nightmares, periodic leg movements, apnea, sweating, heart palpitations
  • Wake time in sleep with pain (e.g., neck, lower back, visceral, tooth)
Wake time symptoms
  • Unrefreshing sleep sensation, fatigue, headache, etc.
  • Sleepiness if driving
  • Anxiety and anger over fulfilling daytime requirements at home or work

From: 3, Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders

Cover of Sleep Disorders and Sleep Deprivation
Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem.
Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, editors.
Washington (DC): National Academies Press (US); 2006.
Copyright © 2006, National Academy of Sciences.

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