I'm tired and it hurts! Sleep quality and acute pain response in a chronic pain population

Woelk, Jamie; Goerlitz, D.; Wachholtz, Amy

doi:10.1016/j.sleep.2019.10.017

Cited by 11 publications

(9 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The VSH scale was originally developed to assess the subjective sleep quality of hospitalised patients but has been used in a variety of populations, including healthy adults, adults with insomnia, hospitalised patients and healthy adults given melatonin. 9,13–15 High scores for sleep disturbance were common in our patients with more than half of participants having a disturbance score of >350 out of 700 and 38% with a score of 500 or more, indicating profound sleep disturbance. In healthy subjects, VSH disturbance scores are reported to be around 100–200.…”

Section: Discussionmentioning

confidence: 75%

Extent of sleep problems and relationship with severity of chronic pain using three validated sleep assessment tools

Vaughan

Galley

Kanakarajan

2021

British Journal of Pain

View full text Add to dashboard Cite

Objective Chronic pain can impact on sleep, but the extent and nature of sleep problems in patients with chronic pain are incompletely clear. Several validated tools are available for sleep assessment but they each capture different aspects. We aimed to describe the extent of sleep issues in patients with chronic non-malignant pain using three different validated sleep assessment tools and to determine the relationship of sleep issues with pain severity recorded using the Brief Pain Inventory (BPI), a commonly used self-assessment tool in pain clinics. The BPI has a single question on the interference of pain on sleep and we also compared this with the validated sleep tools. Design Prospective, cross-sectional study. Setting Pain management clinic at a large teaching hospital in the United Kingdom. Subjects Adult patients (with chronic non-malignant pain of at least 3 months’ duration) attending clinic during a 2-month period. Methods Participants completed the Pittsburgh Sleep Quality Index (PSQI), the Pain and Sleep Questionnaire-3 (PSQ-3) and the Verran Snyder-Halpern (VSH) sleep scale, plus the BPI. Duration and type of pain, current medications and demographic data were recorded. Results We recruited 51 patients and 82% had poor sleep quality as shown by PSQIscores above five. PSQI ( p = 0.0002), PSQ-3 ( p = 0.0032), VSH sleep efficiency ( p = 0.012), sleep disturbance ( p = 0.0014) and waking after sleep onset ( p = 0.0005) scores were associated with worse BPI pain scores. BPI sleep interference scores concurred broadly with the validated sleep tools. Median [range] sleep duration was 5.5 [3.0–10.0] hours and was also related to pain score ( p = 0.0032). Conclusion Chronic pain has a marked impact on sleep regardless of the assessment tool used. The sleep interference question in the BPI could be used routinely for initial identification of sleep problems in patients with chronic pain.

show abstract

Section: Discussionmentioning

confidence: 75%

Extent of sleep problems and relationship with severity of chronic pain using three validated sleep assessment tools

Vaughan

Galley

Kanakarajan

2021

British Journal of Pain

View full text Add to dashboard Cite

show abstract

“…The initial STOP manual was developed based on interviews with our community addiction treatment partners about the needs in their treatment population. We selected empirically validated pain treatments and substance use treatments, such as pain education, pain CBT, OUD CBT, relapse prevention, sleep hygiene, and self-regulation therapies, based on previously identified needs from the psycho-physiological studies [ 19 , 25 , 26 ]. Treatments were modified to address the specific needs of the patient population and coalesced into a 90-min, 12-week, rolling entry group therapy treatment called STOP.…”

Section: Methodsmentioning

confidence: 99%

“…A study was previously conducted on psychophysiology to determine the unique psychological and physiological needs of patients with COAP [ 19 , 24 , 25 ] to provide data that can inform both prescribing practices for pain and OUD as well as behavioral interventions for individuals with COAP. This basic science research compared psychophysiological responses to pain and cravings across 120 individuals with chronic pain: 1) on current opioid-agonist medications for OUD (e.g., methadone and buprenorphine), 2) historical treatment with OUD medications but no current opioids, and 3) opioid naïve participants [ 18 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…Participants struggling with COAP also reported significant difficulties with onset, pattern, quantity, and quality of sleep, which can influence pain perception and opioid cravings [ 25 , 26 ]. Therefore, the STOP therapy protocol should include information on sleep hygiene, quality versus quantity of sleep, and the impact of medications/other substances on sleep quality.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Developing a novel treatment for patients with chronic pain and Opioid User Disorder

Wachholtz

Robinson

Epstein

2022

Subst Abuse Treat Prev Policy

Self Cite

View full text Add to dashboard Cite

Background It is critical to develop empirically based, community-treatment friendly, psychotherapy interventions to improve treatment for patients with comorbid chronic pain and Opioid Use Disorder. Understanding factors that increase patient adherence and attendance is important, along with strategies targeted to address those issues. Methods Based on initial psychophysiology research on adults with OUD and chronic pain, we created an integrated cognitive-behavioral, 12-week outpatient group therapy called STOP (Self-regulation Therapy for Opioid addiction and Pain). In this study, we pilot tested STOP in a Stage 1a feasibility and acceptability study to identify unique treatment needs and factors that increased session attendance, adherence to treatment, and improved outcomes. Fourteen individuals on medication for OUD with co-occurring chronic pain participated. Results STOP had high attendance rates (80%; and active patient engagement). Urine toxicology showed no illicit drug use after week 8. Data analysis from pre-intervention to a 3-month follow-up showed significant functional improvement (F(1,12) = 45.82;p < 0.001) and decreased pain severity levels (F(1,12) = 37.62;p < 0.01). Participants reported appreciation of the unique tools to counteract physiological activation during a pain flare or craving. Participants also reported benefit from in-session visual aids, applicable pain psychology information, take-home worksheets, tools for relaxation practice, learning to apply the therapy tools. Discussion STOP is a 90-min 12-week rolling-entry group therapy based on previous research identifying psychophysiological needs of pain and OUD patients that can be seamlessly incorporated into community addiction treatment clinics. Conclusion Preliminary results of STOP are promising with high patient engagement and adherence and significant reductions in drug use and pain. Trial registration ClinicalTrials.Gov NCT03363243, Registered Dec 6, 2017.

show abstract

“…A study was previously conducted on psychophysiology to determine the unique psychological and physiological needs of patients with COAP (18, 21,22) to provide data that can inform both prescribing practices for pain and OUD as well as behavioral interventions for individuals with COAP. Our basic science research compared psychophysiological responses to pain and cravings across 120 individuals with chronic pain: 1) on current opioid-agonist medications for OUD (e.g., methadone and buprenorphine),…”

Section: Introductionmentioning

confidence: 99%

Lessons Learned: Developing a Better Treatment for Patients With Chronic Pain and Opioid User Disorder

Wachholtz

Robinson

Epstein

2021

Preprint

Self Cite

View full text Add to dashboard Cite

Introduction: It is critical to develop empirically based, community-treatment friendly, psychotherapy interventions to improve treatment for patients with comorbid chronic pain and Opioid Use Disorder (OUD). Understanding factors that increase patient adherence and attendance is important, along with strategies targeted to address those issues.Methods: Based on initial psychophysiology research on adults with OUD and chronic pain, we created an integrated cognitive-behavioral, 12-week outpatient group therapy called STOP (Self-regulation Therapy for Opioid addiction and Pain). In this study, we pilot tested STOP in a Stage 1a feasibility and acceptability study to identify unique treatment needs and factors that increased session attendance, adherence to treatment, and improved outcomes. Fourteen individuals on medication for OUD with co-occurring chronic pain participated.Results: STOP had high attendance rates (80%; and active patient engagement). Urine toxicology showed no illicit drug use after week 8. Data analysis from pre-intervention to a 3-month follow-up showed significant functional improvement (F(1,12)=45.82;p<0.001) and decreased pain severity levels (F(1,12)=37.62;p<0.01). Participants reported appreciation of the unique tools to counteract physiological activation during a pain flare or craving. Participants also reported benefit from in-session visual aids, applicable pain psychology information, take-home worksheets, tools for relaxation practice, learning to apply the therapy tools. Discussion: STOP is a 90-minute 12-week rolling-entry group therapy based on previous research identifying psychophysiological needs of pain and OUD patients that can be integrated into community addiction treatment clinics. Conclusion: Preliminary results of STOP are promising with high patient engagement and adherence and significant reductions in drug use and pain. Trial registration: ClinicalTrials.Gov NCT03363243, Registered Dec 6, 2017, https://clinicaltrials.gov/ct2/show/NCT03363243

show abstract

I'm tired and it hurts! Sleep quality and acute pain response in a chronic pain population

Cited by 11 publications

References 26 publications

Extent of sleep problems and relationship with severity of chronic pain using three validated sleep assessment tools

Extent of sleep problems and relationship with severity of chronic pain using three validated sleep assessment tools

Developing a novel treatment for patients with chronic pain and Opioid User Disorder

Lessons Learned: Developing a Better Treatment for Patients With Chronic Pain and Opioid User Disorder

Contact Info

Product

Resources

About