Negative consequences of sleep disturbance in individuals with limb loss

Abstract Objectives To identify the association between sleep disturbance with physical function and psychological outcomes in individuals with limb loss. Methods This cross-sectional study included 218 community ambulating individuals with at least one amputation, recruited from Military treatment facilities, community events, and prosthetic clinics. Participants’ demographics were obtained from self-reported questionnaires. The Patient-Reported Outcomes Measurement Information System (PROMIS)-29 scores were used to assess sleep disturbance, physical function, anxiety, depression, fatigue, pain interference, and social participation. Sleep disturbance data were used to categorize the participants into three mutually exclusive groups: no sleep disturbance, mild sleep disturbance, and moderate to severe sleep disturbance. One-way analyses of variance (ANOVA) were used to determine if differences existed in PROMIS scores between the three sleep disturbance categories. Results Results showed that as compared to individuals with no sleep disturbance, those with moderate to severe sleep disturbance had worse physical function; higher levels of anxiety, depression, fatigue, and pain interference, and less social participation. In addition, a difference was noted between the mild and the moderate to severe groups indicating worse depression, fatigue, social participation, and pain interference. When compared to the no sleep disturbance group, the mild disturbance group demonstrated worse physical function and fatigue (all P < 0.05). Conclusions Results reflect that higher levels of sleep disturbance are associated with worse functional and psychological outcome measures in individuals with limb loss. Findings from this study also indicate that a higher threshold of sleep disturbance is required to impact levels of depression, social participation, and pain interference.