What part does sleep disturbance play in post-cancer fatigue? Findings from a prospective cohort study.

Abstract Study objectives Patients with migraine commonly endorse napping as a strategy for headache pain relief, but also experience high rates of sleep disturbance. To elucidate the relationship between napping behavior and migraine, we evaluated the association between napping and headache frequency, severity, and intensity among adults with episodic migraine. We also examined the association between daily napping and that night’s sleep. Methods In this six-week prospective cohort study, 97 adults with episodic migraine completed twice-daily headache and sleep electronic diaries and wore a wrist actigraph. We modeled the associations between napping (yes/no) and headaches with conditional logistic regression and daily napping and nighttime sleep with linear regression. Results Over 4,353 study days, participants reported 1,059 headache days and 389 days with naps. More than 80% of participants napped during the study, with mean nap duration of 76.7±62.4 minutes. Naps were more likely to occur on day 2 of headache 35/242 (14.5%) than on non-headache days 279/3294 (8.5%, OR 2.2 [95%CI 1.4,3.4]). Mean nap onset time (14:40h ± 3.3h) was later than headache onset (12:48h ± 5.3h). In adjusted models, napping was associated with an additional 1.1 (95%CI -1.4, 3.6) headache days/month. Naps were not associated with worse self-reported or objective sleep that night. Conclusions Our findings suggest that naps may be an uncommonly used behavioral strategy for prolonged migraine attacks and do not contribute to nightly sleep disturbance. Future studies are needed to examine the acute analgesic effects of daytime napping in patients with migraine.

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POS1103 SLEEP DISTURBANCE AND BONE MINERAL DENSITY, RISK OF FALLS AND FRACTURE: RESULTS FROM A 10.7-YEAR PROSPECTIVE COHORT STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.376 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 832.1-832

Author(s):

F. Pan ◽

J. Tian ◽

F. Cicuttini ◽

G. Jones

Keyword(s):

Bone Mineral Density ◽

Cohort Study ◽

Sleep Disturbance ◽

Bone Mineral ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Mineral Density ◽

Falls Risk ◽

Increased Risk ◽

Risk Of Falls

Background:Sleep problems are common in the general population and have been reported to adversely affect bone health and increase risk of falls and fracture. However, no study has investigated whether an increased risk of fracture is attributable to sleep-related low bone mineral density (BMD) and/or an increased risk of falls.Objectives:This study, therefore, sought to describe the associations of sleep disturbance with BMD, risk of falls and fractures.Methods:The analyses were performed in a population-based prospective cohort study with 1,099 participants (aged 50–80 years) enrolled at baseline, and 875, 768 and 563 participants traced at a mean follow-up of 2.6, 5.1 and 10.7 years, respectively. At each visit, self-reported sleep disturbance was recorded. BMD (by DXA), falls risk and fracture were measured at each visit. The short-form Physiological Profile Assessment was used to measure falls risk expressed as Z-score. Fractures were self-reported. Mixed-effects model and generalised estimating equations were used for the analyses.Results:In multivariable analysis, there was a dose-response relationship between extent of sleep disturbance and falls risk score with the strongest association in those reporting the worst sleep disturbance (β=0.15/unit; 95%CI 0.02-0.28). The worst sleep disturbance was associated with an increased risk of any (relative risk [RR] 1.30/unit; 95%CI 1.01-1.67) and vertebral fracture (RR 2.41/unit; 95%CI 1.00-5.80) compared with those reporting no interrupted sleep. This was independent of covariates, hip BMD and falls risk. There was no statistically significant association between sleep disturbance and BMD at hip, spine or total body.Conclusion:Sleep disturbance was independently associated with a greater falls risk score and an increased risk of fractures, suggesting that correcting sleep disturbance has the potential to reduce both falls risk and fractures.Disclosure of Interests:None declared.

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