Assessing and Managing Sleep Disturbance in Patients with Chronic Pain

Cheatle, Martin D.; Foster, Simmie L.; Pinkett, Aaron; Lesneski, Matthew; Qu, David; Dhingra, Lara

doi:10.1016/j.anclin.2016.01.007

Cited by 111 publications

(77 citation statements)

References 79 publications

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“…For example, longitudinal studies show that loneliness predicted changes in depressive symptoms in a variety of populations such as children, patients with cancer and HIV, adolescents, college freshmen, the elderly, and healthy adults (Cacioppo, Hawkley, & Thisted, 2010; Cacioppo, Hughes, Waite, Hawkley, & Thisted, 2006a; Grov, Golub, Parsons, Brennan, & Karpiak, 2010; Heikkinen & Kauppinene, 2004; Jaremka et al, 2013, 2014; Qualter, Brown, Munn, & Rotenberg, 2010; Reyes-Gibby, Aday, Anderson, Mendoza, & Cleeland, 2006; Segrin, 1999; Vanhalst et al, 2012; Wei, Russell & Zakalik, 2005). People who are lonelier also tend to engage in less physical activity and have higher rates of sleep disturbance, both of which are related to increased pain and depressive symptoms (Cheatle et al, 2016; Emery, Wilson, & Kowal, 2014; Harrison, Wilson, Heron, Stannard, & Munafò, 2016; Hawkley, Thisted, & Cacioppo, 2009; Jaremka et al, 2013, 2014; Landmark, Romundstad, Borchgrevink, Kaasa, & Dale, 2011). …”

Section: Introductionmentioning

confidence: 99%

Loneliness Mediates the Relationship Between Pain During Intercourse and Depressive Symptoms Among Young Women

2018

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Previous research suggests that women who experience pain during intercourse also experience higher rates of depressive symptoms. Loneliness might be one factor that contributes to this relationship. We hypothesized that women who experience more severe and interfering pain during intercourse would report higher rates of loneliness and higher rates of depressive symptoms. Further, we hypothesized that loneliness would mediate the relationship between pain during intercourse and depressive symptoms. A total of 104 female participants (85.6% white, 74.03% partnered, 20.9 [3.01] years old) completed an online survey including demographic information, PROMIS Vaginal Discomfort Measure, PROMIS Depression Measure, and Revised UCLA Loneliness Scale. Pearson correlations and bootstrapped mediation analysis examined the relationships among pain during intercourse, loneliness, and depressive symptoms. Pain during intercourse, loneliness, and depressive symptoms were all significantly correlated (p < .05). Results of the mediation analysis indicated that loneliness was a significant mediator of the relationship between pain during intercourse and depressive symptoms (indirect effect = 0.077; 95% CI 0.05–0.19). After accounting for loneliness, pain during intercourse was not significantly related to depressive symptoms, suggesting that loneliness fully mediated the relationship between pain during intercourse and depressive symptoms. These findings are consistent with previous studies highlighting that pain during intercourse is related to depressive symptoms. The current study adds to that literature and suggests that more frequent and severe pain during intercourse leads to more loneliness, which then leads to increased depressive symptoms. This line of work has important implications for treating women who experience depressive symptoms and pain during intercourse.

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Section: Introductionmentioning

confidence: 99%

Loneliness Mediates the Relationship Between Pain During Intercourse and Depressive Symptoms Among Young Women

2018

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“…Health systems should consider widespread implementation of behavioral interventions for patients with chronic pain such as CBT. Many of these interventions are well developed, efficacious, cost effective, and specifically focused on improving sleep . One recent randomized trial evaluated a CBT intervention for the treatment of comorbid insomnia and chronic pain and found significant improvements in both sleep and disability from pain .…”

Section: Implications/conclusionmentioning

confidence: 99%

The Mediating Effect of Sleep Disturbance on the Relationship Between Nonmalignant Chronic Pain and Suicide Death

et al. 2019

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Importance Few studies have examined the relationship between nonmalignant chronic pain (NMCP) and suicide death, and even fewer have specifically explored what role sleep disturbance might play in the association between NMCP and suicide death. Objective To assess whether sleep disturbance mediates the relationship between NMCP and suicide death. Design This case‐control study included 2,674 individuals who died by suicide between 2000 and 2013 (cases) and 267,400 matched individuals (controls). Setting Eight Mental Health Research Network (MHRN)‐affiliated healthcare systems. Participants All cases and matched controls were health plan members for at least 10 months during the year prior to the index date. Main Outcomes and Measures Sociodemographic data and diagnosis codes for NMCP and sleep disorders were extracted from the MHRN's Virtual Data Warehouse. Suicide mortality was identified using International Statistical Classification of Diseases and Related Health Problems (ICD)‐10 codes from official government mortality records matched to health system records. Results After accounting for covariates, there was a significant relationship between NMCP and sleep disturbance; those who were diagnosed with NMCP were more likely to develop subsequent sleep disturbance. Similarly, sleep disturbance was significantly associated with suicide death. Finally, a significant indirect effect of NMCP on suicide death, through sleep disturbance, and a nonsignificant direct effect of NMCP on suicide death provide support for a fully mediated model. Conclusions and Relevance There is a need for clinicians to screen for both sleep disturbance and suicidal ideation in NMCP patients and for health systems to implement more widespread behavioral treatments that address comorbid sleep problems and NMCP.

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“…Therefore, and although there are no conclusive data regarding the prevalence of poor sleep quality in FM, the results presented reveal that it is a recurrent and a concerning symptom among these patients [9]. Furthermore, poor sleep quality has been shown to be related with increases in the intensity of pain, and it is an aggravating factor of other FM symptoms such as fatigue, cognitive problems and quality of life [7,10].Taking into account all these data, the assessment of sleep quality could guarantee comprehensive assistance in patients with FM and can provide important information on the effectiveness of prescribed treatments, both pharmacological and non-pharmacological [11]. In the field of research, the assessment of sleep quality may be of especial interest when evaluating the effectiveness of new treatments, and also to improve the knowledge on how this symptom can influence the general health status of people who suffer from FM [10].Therefore, the main objective of this systematic review was to identify and describe the available PROMs of sleep quality in adults diagnosed with FM and their psychometric properties.…”

mentioning

confidence: 99%

“…Taking into account all these data, the assessment of sleep quality could guarantee comprehensive assistance in patients with FM and can provide important information on the effectiveness of prescribed treatments, both pharmacological and non-pharmacological [11]. In the field of research, the assessment of sleep quality may be of especial interest when evaluating the effectiveness of new treatments, and also to improve the knowledge on how this symptom can influence the general health status of people who suffer from FM [10].…”

mentioning

confidence: 99%

Patient Reported Outcome Measures of Sleep Quality in Fibromyalgia: A COSMIN Systematic Review

Climent‐Sanz

Marco-Mitjavila

Pastells-Peiró

et al. 2020

IJERPH

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Poor sleep quality is a common concern and a troublesome symptom among patients suffering from fibromyalgia. The purpose of this review was to identify and describe the available patient reported outcome measures (PROMs) of sleep quality validated in adult people diagnosed with fibromyalgia. The COSMIN and PRISMA recommendations were followed. An electronic systematized search in the electronic databases PubMed, Scopus, CINAHL Plus, PsycINFO, and ISI Web of Science was carried out. Validation studies of PROMs of sleep quality in fibromyalgia published in English or Spanish were included. The selection of the studies was developed through a peer review process through the online software "COVIDENCE". The quality of the studies was assessed using the COSMIN Risk of Bias checklist. A total of 5 PROMs were found validated in patients with fibromyalgia: (1) Pittsburgh Sleep Quality Index (PSQI), (2) Jenkins Sleep Scale (JSS), (3) Sleep Quality Numeric Rating Scale (SQ-NRS), (4) Medical Outcomes Study-Sleep Scale (MOS-SS), and (5) Fibromyalgia Sleep Diary (FSD). The quality of the evidence was very good and the quality of the results ranged from moderate to high. All the included PROMs, except for the FSD, showed adequate psychometric properties and, therefore, are valid and reliable tools for assessing sleep quality in the context of FM. However, none of the studies analyzed all the psychometric properties of the included PROMs as established in the COSMIN guidelines, highlighting that this is a potential field of research for future investigations. out in all experimental studies about FM. These results are in line with a previous internet survey, including 2596 people with FM [4], showing that poor sleep quality, together with pain, fatigue and morning stiffness, are the symptoms with greater severity and impact in these patients. Specifically, 79% of the participants perceived that sleep problems were one of the most common factors in the exacerbation of FM symptoms [4].In terms of prevalence, the studies indicate that between 65% and 99% of people diagnosed with FM report poor sleep quality [5][6][7]. Other authors [8] state that 63% of these patients report two or more symptoms of difficulty sleeping, while only 11.2% report having no problem sleeping. A recent meta-analysis of case-control studies indicated that, in comparison with healthy controls, people with FM show significantly lower sleep efficiency and sleep quality, shorter sleep duration, longer wake time after sleep onset and more percentage of light sleep stages when assessed with polysomnography. Subjective assessment showed that patients with FM have more difficulties falling asleep and worse sleep efficiency. Therefore, and although there are no conclusive data regarding the prevalence of poor sleep quality in FM, the results presented reveal that it is a recurrent and a concerning symptom among these patients [9]. Furthermore, poor sleep quality has been shown to be related with increases in the intensity of pain, and it is an aggravating factor o...

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Assessing and Managing Sleep Disturbance in Patients with Chronic Pain

Cited by 111 publications

References 79 publications

Loneliness Mediates the Relationship Between Pain During Intercourse and Depressive Symptoms Among Young Women

Loneliness Mediates the Relationship Between Pain During Intercourse and Depressive Symptoms Among Young Women

The Mediating Effect of Sleep Disturbance on the Relationship Between Nonmalignant Chronic Pain and Suicide Death

Patient Reported Outcome Measures of Sleep Quality in Fibromyalgia: A COSMIN Systematic Review

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