Assessment of sleep in patients with chronic pain

Vaughan, R.; Galley, Helen F.; Kanakarajan, Saravanakumar

doi:10.1016/j.bja.2017.11.029

Cited by 4 publications

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“…There was insufficient evidence of the benefit of melatonin in BMS. The relationship between pain and sleep is inextricable, in which poor sleep quality is a risk factor for chronic pain development, and pain disrupts the sleep pattern ( 98 ). Melatonin is a neurohormone that regulates the circadian biological rhythms.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of treatment for patients with burning mouth syndrome

et al. 2021

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Background Burning mouth syndrome is a chronic idiopathic intractable intraoral dysaesthesia that remains a challenge to clinicians due to its poorly understood pathogenesis and inconsistent response to various treatments. Aim This review aimed to study the short- (≤3 months) and long-term (>3 months) effectiveness and sustainable benefit of different burning mouth syndrome treatment strategies and the associated side effects. Materials and methods Randomised controlled trials of burning mouth syndrome treatment compared with placebo or other interventions with a minimum follow up of 2 months were searched from the PubMed, Embase and Cochrane database (published to July 2020). Results Twenty-two studies were selected based on the inclusion and exclusion criteria and analysed. Nine categories of burning mouth syndrome treatment were identified: Anticonvulsant and antidepressant agents, phytomedicine and alpha lipoic acid supplements, low-level laser therapy, saliva substitute, transcranial magnetic stimulation, and cognitive behaviour therapy. Cognitive behaviour therapy, topical capsaicin and clonazepam, and laser therapy demonstrated favourable outcome in both short- and long-term assessment. Phytomedicines reported a short-term benefit in pain score reduction. The pooled effect of alpha lipoic acid (ALA) pain score improvement was low, but its positive effects increased in long term assessment. Conclusion A more significant volume in terms of sample size, multi-centres, and multi-arm comparison of therapeutic agents with placebo and longitudinal follow-up studies is recommended to establish a standardised burning mouth syndrome treatment protocol. Further studies are required to assess the analgesic benefits of topical clonazepam and capsaicin, alternative medicines with neurodegenerative prevention capability and psychology support in treating burning mouth syndrome and reducing systemic adverse drug reactions. Registration International Prospective Register of Systematic Reviews (PROSPERO): Protocol ID - CRD42020160892.

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Section: Discussionmentioning

confidence: 99%

A systematic review of treatment for patients with burning mouth syndrome

et al. 2021

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“…Chronic non-cancer pain (CNCP) is defined as pain that is not resolved in an expected time-frame, does not respond to acceptable analgesic treatment, and lasts more than three months ( Tunks et al, 2008 ). CNCP has a negative impact on sleep ( Vaughan et al, 2018 ) and on patients’ physical, psychological and social wellbeing, which when combined, are often defined as health-related quality of life (QoL) ( Jensen et al, 2007 ). QoL is one of the important outcome domains being measured in the evaluation of pain treatment effectiveness and has been suggested to be indicative of treatment success ( Börsbo et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Prolonged Medical Cannabis Treatment is Associated With Quality of Life Improvement and Reduction of Analgesic Medication Consumption in Chronic Pain Patients

et al. 2021

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Introduction: Chronic non-cancer pain (CNCP) is one of the most prevalent indications for medical cannabis (MC) treatment globally. In this study, we investigated CNCP parameters in patients during prolonged MC treatment, and assessed the interrelation between CNCP parameters and the chemical composition of MC chemovar used.Methods: A cross-sectional questionnaire-based study was performed in one-month intervals for the duration of six months. Subjects were adult patients licensed for MC treatment who also reported a diagnosis of CNCP by a physician. Data included self-reported questionnaires. MC treatment features included administration route, cultivator, cultivar name and monthly dose. Comparison statistics were used to evaluate differences between the abovementioned parameters and the monthly MC chemovar doses at each time point.Results: 429, 150, 98, 71, 77 and 82 patients reported fully on their MC treatment regimens at six one-month intervals, respectively. Although pain intensities did not change during the study period, analgesic medication consumption rates decreased from 46 to 28% (p < 0.005) and good Quality of Life (QoL) rates increased from 49 to 62% (p < 0.05). These changes overlapped with increase in rates of (-)-Δ9-trans-tetrahydrocannabinol (THC) and α-pinene high dose consumption.Conclusion: Even though we observed that pain intensities did not improve during the study, QoL did improve and the rate of analgesic medication consumption decreased alongside with increasing rates of high dose THC and α-pinene consumption. Understanding MC treatment composition may shed light on its long-term effects.

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“…The primary outcome measure is improved sleep disturbance, measured using the Verran Snyder-Halpern (VSH) scale,31 which assesses sleep over the previous 24 hours. Our previous study showed that patients with mild pain (average pain score of 4 or less) compared with severe pain (scoring 7 or more) had median VSH sleep disturbance scores of 147 and 490, respectively 6. Assuming a conservative treatment effect difference of 120 (effect size=0.60), we need a minimum of 46 patients to achieve 80% power.…”

Section: Methods and Analysismentioning

confidence: 99%

“…Epidemiological reports suggest that over 50% of individuals with chronic pain experience disturbed sleep 2–5. The risk of poor sleep quality increases as patient-reported pain intensity increases 6. Both chronic pain and sleep disturbance independently diminish quality of life and have a detrimental effect on mental health and well-being 5.…”

Section: Introductionmentioning

confidence: 99%

Phase II double-blind randomised controlled trial of exogenous administration of melatonin in chronic pain (DREAM—CP): a study protocol

Adam¹,

Kanakarajan

Onyeakazi

et al. 2020

BMJ Open

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IntroductionChronic pain is prevalent, and approximately half of patients with chronic pain experience sleep disturbance. Exogenous melatonin is licensed to treat primary insomnia and there is some evidence for analgesic effects of melatonin.The aim of this study is to investigate the effects of oral melatonin (as Circadin) 2 mg at night in adults with severe non-malignant pain of at least 3 months’ duration.Methods and analysisWe will conduct a randomised double-blind placebo-controlled cross-over study. The primary outcome is sleep disturbance. Secondary outcomes are pain intensity, actigraphy, fatigue, reaction time testing, serum melatonin and endogenous opioid peptide levels along with patient views about study participation.We aim to recruit 60 patients with severe chronic pain (average pain intensity ≥7 on the Brief Pain Inventory (BPI)) from a tertiary referral pain clinic in Northeast Scotland. Participants will be randomised to receive melatonin (as modified release Circadin) 2 mg daily for 6 weeks or placebo, followed by a 4-week washout period, then 6 weeks treatment with the treatment they did not receive. Participants will complete the Verran Snyder-Halpern Sleep Scale, Pittsburgh Sleep Quality Index, Pain and Sleep Questionnaire 3-item index, BPI and psychomotor vigilance reaction time testing at 6 points over 20 weeks. Actigraphy watches will be used to provide objective measures of sleep duration and latency and other sleep measures and will prompt patients to report contemporaneous pain and fatigue scores daily.Cross-over analyses will include tests for effects of treatment, period, treatment–period interaction (carryover effect) and sequence. Within-patient effects and longitudinal data will be analysed using mixed linear models, accounting for potential confounders.Ethics and disseminationApproved by Office for Research Ethics Committees Northern Ireland, reference 19/NI/0007. Results will be published in peer-reviewed journals and will be presented at national and international conferences.Trial registration numberISRCTN12861060

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Assessment of sleep in patients with chronic pain

Cited by 4 publications

References 0 publications

A systematic review of treatment for patients with burning mouth syndrome

A systematic review of treatment for patients with burning mouth syndrome

Prolonged Medical Cannabis Treatment is Associated With Quality of Life Improvement and Reduction of Analgesic Medication Consumption in Chronic Pain Patients

Phase II double-blind randomised controlled trial of exogenous administration of melatonin in chronic pain (DREAM—CP): a study protocol

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