BRIEF RESEARCH REPORT article
Front. Pain Res.
Sec. Pharmacological Treatment of Pain
Volume 6 - 2025 | doi: 10.3389/fpain.2025.1589748
This article is part of the Research TopicPain-Related Sleep Impairment: Expression, Mechanisms, and Treatment StrategiesView all articles
Sleep Hygiene Linked to Patient-Reported Outcomes & Objective Sleep Measures Prior to Upper Extremity Orthopaedic Surgery
Provisionally accepted
Nicholas Giordano*
Tatiana Getz
Michael Gottschalk
Andrew H MillerKim Dupree JonesJasmine ParkYining ZhuAnnabelle Gong
Jack HudsonSarah M TaubAmanda K KloskySelma SelimovicEric R Wagner- Emory University, Atlanta, United States
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Background: Despite being modifiable, sleep hygiene is rarely assessed preoperatively and may be a driver of the relationship between poor sleep quality and pain response in surgical patient populations. Furthermore, there is a dearth of research examining the relationship between sleep hygiene and objective sleep measures in an ambulatory surgical patient population.Purpose: This analysis examined the association between sleep hygiene habits and both pain and sleep quality in a sample of patients undergoing orthopaedic surgery utilizing patient-reported outcomes and objective longitudinal measures of sleep quality, known as actigraphy.Methods: Participants undergoing orthopaedic surgery on their upper extremity were recruited, consented, and enrolled in this study approximately 2 weeks before surgery. Participants completed the Sleep Hygiene Index and PROMIS Pain Interference measure. In addition, participants wore an actigraphy device to measure sleep efficiency and total sleep time.Results: This sample included 30 participants. The average Sleep Hygiene Index score was 10.87, and the sample's average PROMIS Pain Interference T-score was 63.73. Actigraphy derived total sleep time per day was 362.97 minutes and an average sleep efficiency score of 91.98. Regression models showed that poorer sleep hygiene (e.g., higher scores) was associated with worse PROMIS Pain Interference T-scores(p=.04). In addition, participants with worse sleep hygiene scores had worse sleep efficiency (p=.037) and had fewer minutes in their total sleep time (p=.034).Conclusion: This analysis indicates that poorer sleep hygiene is associated with both increased pain interference and poorer sleep quality among patients about to undergo orthopaedic surgery on their upper extremity.
Keywords: Actigraphy, Orthopaedic surgery, Pain, Sleep Hygiene, sleep quality
Received: 07 Mar 2025; Accepted: 13 May 2025.
Copyright: © 2025 Giordano, Getz, Gottschalk, Miller, Dupree Jones, Park, Zhu, Gong, Hudson, Taub, Klosky, Selimovic and Wagner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Nicholas Giordano, Emory University, Atlanta, United States
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