Disrupted sleep before gynecologic cancer surgery and increased postoperative pain

9555 Background: Despite the best clinical care, pain following gynecologic surgery for cancer is a virtually universal patient experience that can have pervasive negative consequences. Given the sometimes prolonged impact of such pain, and the large variability across patients, additional research on modifiable presurgery risk factors is needed. Recent experimental studies have found that sleep disruption may increase pain sensitivity the next day in healthy volunteers. The possible negative effects of poor sleep prior to cancer surgery have not been investigated despite the likelihood that sleep may be particularly disrupted at that time. We hypothesized that sleep before surgery (at a gynecologic oncology practice) would be disrupted compared with healthy women not anticipating surgery. Within the patient group we further hypothesized that disrupted sleep would predict increased postoperative pain. Methods: Sleep disruption (% of time awake in the sleep period) and sleep duration (minutes asleep) were measured in 52 women (15 patients; 38 healthy comparisons) using an actigraph device for 10 nights, commencing 3 nights before surgery. Pain intensity was measured in the patient group using the Brief Pain Inventory 7 days postsurgery. Statistical analyses included univariate analyses of variance and multiple regression. Results: Sleep disruption but not sleep duration, averaged over the three nights before surgery, was significantly greater in the surgery group compared with the healthy comparison group (F=10.0, p=.003). In the patient group increased pain intensity was predicted by heightened sleep disruption (B=−.86, C.I. −.23 to −.099, p=.0001) and lower sleep duration (B=−.48, C.I. −.03 to −.001, p=.033) when controlling for age, surgery duration, presurgery mood and postoperative sleep. Conclusions: This study is the first to document adverse effects of prior sleep disruption and duration on pain in a clinical oncology context. Future research should explore mechanisms responsible for these effects and examine the impact of interventions to improve sleep prior to surgery. No significant financial relationships to disclose.