Chronic pain after spinal injury: Interference with sleep and daily activities

Widerström-Noga, Eva; Felipe-Cuervo, Ernesto; Yezierski, Robert P.

doi:10.1053/apmr.2001.26068

Cited by 210 publications

(164 citation statements)

References 42 publications

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“…[11][12][13][14]31 However, pain severity was found to be predictive for falling asleep and for staying asleep in a study on patients with spinal cord injuries. 17 Relation between pain and sleep Several studies have reported that patients with pain report poorer sleep quality. Simply the presence of pain or its intensity is rarely predictive of this.…”

Section: Discussionmentioning

confidence: 99%

“…Spasms, pain and paresthesia, and troubles with voiding were found to be associated with poor sleep quality. Regarding the interference of pain with sleep disturbances in the spinal cord injured, Widerstro¨m-Noga et al 17 found that higher pain intensity was associated with poorer subjective sleep quality, that is, falling asleep and staying asleep. Rintala et al 8 also found chronic pain to interfere with sleep in individuals with an SCI.…”

Section: Introductionmentioning

confidence: 99%

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Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain

2004

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Study design: A cross-sectional descriptive study of self-reported quality of sleep in individuals with a spinal cord injury (SCI). Objectives: To assess and describe subjective quality of sleep in patients with SCI, with and without pain. Setting: Spinalis SCI unit, Stockholm, Sweden. Methods: A total of 230 patients with an SCI were mailed a questionnaire containing queries about pain intensities, pain unpleasantness, mood, and sleep quality (Basic Nordic Sleep Questionnaire) to assess quality of sleep in patients with SCI with and without pain. Results: Of the 192 questionnaires that were returned (response rate 83.4%), 191 were analysed. Patients were divided into three groups: (1) those who reported no pain (n ¼ 50), (2) those who reported intermittent pain (n ¼ 42), and (3) those who suffered from continuous pain (n ¼ 99). Patients suffering from continuous pain rated pain intensity and unpleasantness significantly higher than those who only suffered from intermittent pain. The group with continuous pain also reported the poorest quality of sleep and the highest ratings of anxiety and depression of the three groups. Anxiety, together with pain intensity and depression, were the main predictors for poor sleep quality. Conclusions: Poor subjective sleep quality was associated with higher ratings of pain intensity, anxiety, and depression. It is possible that melatonin serves as a modulator of these different aspects. Sponsorship: This study was made possible by grants from Spinalis Foundation.Spinal Cord (2005) 43, 85-95.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain

2004

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“…1,6 Fatigue has been reported as an issue for people with spinal cord injury (SCI); [10][11][12][13] however, estimates on the prevalence of fatigue in this population and identification of the variables that explain the presence of fatigue severity are not clearly delineated in the literature. For example, some clinical variables such as chronic pain and sleep disturbance and various demographic factors such as sex, country of residence and age have been found to be associated with fatigue after SCI, 11,12,14,15 yet little is known about the independent contributions in explaining fatigue among these variables. Although the association between age and fatigue among individuals with SCI has received some attention, the findings have been somewhat conflicting.…”

Section: Introductionmentioning

confidence: 99%

Clinical correlates of fatigue in spinal cord injury

et al. 2007

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Study design: Retrospective chart review. Objectives: To determine the prevalence of fatigue in an outpatient spinal cord injury population and to examine the clinical variables contributing to that fatigue. Setting: GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada. Methods: Medical charts of 76 individuals admitted to the GF Strong Outpatient SCI Program between December 2004 and December 2005 were reviewed. Data collected included information on clinical characteristics, demographics and Fatigue Severity Scale (FSS) scores. Multivariable analysis was completed to determine the independent association between these variables and fatigue severity. Results: A total of 57% (95% confidence interval (CI) ¼ 45-67%) of the sample were found to have fatigue severe enough to interfere with function. People that were admitted for medical reasons; had pain, spasticity, incomplete injuries, and/or were on more that one medication with a known side effect of fatigue had significantly higher FSS scores. Multivariable analysis indicated incomplete injury was the only statistically significant predictor of a higher FSS scores; pain approached significance (P ¼ 0.07, CI ¼ À0.09, 2.06). Together these variables account for 18% of the variance in FSS scores in this sample. Conclusion: Fatigue among individuals with spinal cord injury who are seeking outpatient rehabilitation is very common. The severity of fatigue was greater for individuals with incomplete lesions. Pain was also a potentially important covariate of fatigue. Further research is required to determine what else contributes to fatigue severity beyond these clinical variables as only minimal variance was accounted for in our model.

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“…They take more sleeping pills, and their snores are prolonged and more frequent than those of healthy persons. 1,2 These sleep disturbances may be caused by spastic muscle contractions, pain, sensory disturbances, or incontinence. Impairment of the sleep-wake cycle, a possible consequence of a cervical SCL, may also contribute to these disturbances.…”

Section: Introductionmentioning

confidence: 99%

The feasibility of sleep assessment by actigraph in patients with tetraplegia

2007

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Background: Sleep disturbances are frequent in patients with high spinal cord lesions, and are difficult to diagnose by means of polysomnography (PSG). Design: Retrospective cohort study. Objective: Examine the feasibility of sleep assessment by actigraph in patients with tetraplegia. Setting: A rehabilitation center in Israel. Subjects: Twenty-one patients with tetraplegia and 20 healthy persons. Interventions: Sleep assessment by actigraphs attached to the head and the wrist. Main outcome measures: The actigraphic movement index (MI), total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), sleep latency (SL), and number of awakenings (NOA). Results: In the control group actigraphy showed that during sleep the hand moves more than the head but that the movements were highly correlated. In patients with tetraplegia below C 5 -C 7 the hand also moved more than the head, but in patients with tetraplegia below C 4 , the head moved more (Po0.05). No significant differences were found between patients with C 5 -C 7 tetraplegia and healthy controls in the sleep indices obtained by hand movements, or between patients with C 4 tetraplegia and healthy controls in the indices obtained by head movements. Control subjects and patients showed similar subjective assessment of sleep quality. Conclusions: These preliminary findings support the validity of wrist actigraphy for sleep assessment in patients with C 5 -C 7 tetraplegia, and suggest that head-mounted actigraphy is a feasible alternative for sleep assessment in patients with tetraplegia below C 4 . To establish these findings, further investigations are required, with a larger number of patients and comparison with PSG.

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Chronic pain after spinal injury: Interference with sleep and daily activities

Cited by 210 publications

References 42 publications

Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain

Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain

Clinical correlates of fatigue in spinal cord injury

The feasibility of sleep assessment by actigraph in patients with tetraplegia

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