Last Updated: 2009-04-17 16:27:54 -0400 (Reuters Health)

Women who sleep poorly the night before they undergo surgery to diagnose or treat breast cancer have increased postoperative pain, say researchers from the Mount Sinai School of Medicine in New York.

In the March issue of the Journal of Pain and Symptom Management, Dr. Caroline E. Wright and colleagues report on 24 women who agreed to wear a sleep-monitoring device the night before routine breast-conserving surgery. The actigraphy device provided objective validated measures of sleep duration (total sleep time) and disruption (low sleep efficiency). On postoperative day 7, pain severity and interference with activities of daily living were assessed with the Brief Pain Inventory.

Overall, the mean scores for pain severity and interference with daily activities were 2.96 and 2.48, respectively, with 13 patients (54.2%) experiencing mild pain and 11 (45.8%) having moderate to severe pain at some point during the week after surgery.

On multiple regression analysis, lower sleep efficiency was significantly associated with greater pain severity and interference.

Compared to women in the highest sleep efficiency tertile, those in the lowest tertile had 59% higher mean pain severity scores and 64% higher mean pain interference scores.

Lower sleep efficiency was not, however, associated with depressed mood, emotional upset, or relaxation as assessed on the morning of surgery.

"Although these initial findings need to be replicated in larger, more diverse samples, the results have important implications for the clinical care of patients about to undergo surgery," Dr. Wright’s team concludes.

J Pain Symptom Manage 2009;37:352-362.