Major Depressive Disorder and Sleep Disturbance in Patients with Chronic Pain

Emery, Patricia; Wilson, Keith G.; Kowal, John

doi:10.1155/2014/480859

Cited by 51 publications

(37 citation statements)

References 73 publications

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“…This was largely in line with expectations and previous research showing the separate relationships between these factors and pain [12,14,61]. Of note is the lack of significant correlation between pain and sleep apnoea or restless legs syndrome after applying the Holm-Bonferroni adjustment.…”

Section: Correlates With Pain and Low Physical Functionsupporting

confidence: 91%

“…This is the case both for total sleep deprivation and deprivation of specific sleep stages, thereby mimicking poor sleep quality [9,11]. Moreover, sleep problems may act as a risk factor for developing chronic pain [8]; indeed, many patients with chronic pain pinpoint improved sleep as an important goal of treatment for their pain [12,13]. However, the relationship between sleep and pain is complex, as depression and catastrophizing correlate highly both with pain and sleep problems [12,14].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, sleep problems may act as a risk factor for developing chronic pain [8]; indeed, many patients with chronic pain pinpoint improved sleep as an important goal of treatment for their pain [12,13]. However, the relationship between sleep and pain is complex, as depression and catastrophizing correlate highly both with pain and sleep problems [12,14]. Thus, pain, psychological factors and sleep may all interact.…”

Section: Introductionmentioning

confidence: 99%

“…Approximately 25% to 55% of patients with chronic pain meet the diagnostic criteria for Major Depressive Disorder (MDD) [12,[15][16][17][18][19]. Not only is the prevalence of comorbid depression and chronic pain high, but psychological factors such as depression also contribute significantly to variance in acute and chronic pain [20].…”

Section: Introductionmentioning

confidence: 99%

“…In fact, having a chronic sleep problem such as insomnia is one of the defining symptoms of Major Depression [12,19].…”

Section: Introductionmentioning

confidence: 99%

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Sleep Problems are Associated With Chronic Pain Over and Above Mutual Associations With Depression and Catastrophizing

Roberts

Drummond

2016

The Clinical Journal of Pain

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Pain, mood problems and sleeping difficulties are often comorbid and contribute to reduced physical function and quality of life for those suffering from chronic pain. However, the way in which these factors interact is unclear. Until recently it was thought that the effect of sleep on pain and physical function was simply a result of its common association with mood problems. However, a growing body of research suggests that sleep may have a unique contribution.Objectives: The aim of this study was to determine whether sleep disturbances were associated with pain and poor physical function independent of psychological distress in patients attending a tertiary pain medicine unit.Method: 101 patients with chronic pain completed a set of questionnaires measuring pain, sleep and mood, and also completed a selection of physical assessments conducted by a physiotherapist.Results: 75.2% of participants had insomnia and 84.3% reported the presence of at least one sleep problem. Significant positive correlations with pain were detected for depression, catastrophizing, insomnia, short sleep duration and poor sleep quality. Sleep duration had a significant independent association with pain after accounting for depression and catastrophizing. Sleep duration also had an independent association with physical function after accounting for pain and catastrophizing.Conclusions: Given that sleep has an important and unique contribution to pain and physical function, it is important that sleep disturbances are addressed both in the assessment and treatment of chronic pain.

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Section: Correlates With Pain and Low Physical Functionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In fact, having a chronic sleep problem such as insomnia is one of the defining symptoms of Major Depression [12,19].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sleep Problems are Associated With Chronic Pain Over and Above Mutual Associations With Depression and Catastrophizing

Roberts

Drummond

2016

The Clinical Journal of Pain

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The pain–depression dyad and the association with sleep dysfunction in chronic rhinosinusitis

Cox

Ashby

Mace

et al. 2016

Int Forum Allergy Rhinol

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Background Depression, pain, and sleep disturbance is a symptom cluster often found in patients suffering from chronic illness, exerting a large impact on quality-of-life (QOL). A wealth of literature exists demonstrating a significant association between depression, pain, and sleep dysfunction in other chronic diseases. This relationship has not been described in patients with chronic rhinosinusitis (CRS). Methods Sixty-eight adult patients with CRS were prospectively enrolled. Patients at risk for depression were identified using the Patient Health Questionnaire-2 (PHQ-2) using a cutoff of 1 or greater. Pain experience was measured using the Brief Pain Inventory Short Form (BPI-SF) and the Short Form McGill Pain Questionnaire (SF-MPQ). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Results Forty-seven patients were at risk for depression. Significant positive correlations were found between total PSQI scores and all pain measures (R=0.38–0.61, p≤0.05) and between total PSQI scores and PHQ-2 scores (R=0.46, p<0.05). For patients at risk for depression, significant, positive correlations were found between pain measures, the total PSQI score, and the three PSQI subdomains (sleep latency, sleep quality, and daytime dysfunction; R=0.31-0.61, p<0.05). The relationship between pain and sleep dysfunction scores was not seen in the absence of depression. Conclusions Depression, pain, and sleep dysfunction are inter-related in patients with CRS. In the absence of depression significant correlations between pain and sleep are not observed, suggesting that depression plays a key role in this interaction. Further research investigating the complex relationship between depression, pain, and sleep dysfunction in CRS is needed.

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Association between night pain and quality of life in women: A general population sleep study

Lucena

Lavigne

Fabbro

et al. 2022

European Journal of Pain

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Background Women with pain present decreased sleep duration and quality of life, but little is known about the consequences of nighttime pain on overall health. Our goal was to compare levels of anxiety, depression and fatigue in women with pain during the night with those without pain. We hypothesized that pain perception is associated with the worsening of fatigue and mood. Methods In total, 244 women aged 20–80 years who took part in the Epidemiologic Sleep Study (EPISONO) met the inclusion criteria, 85 in the self‐reported pain group and 171 in the control group. Participants were assigned to the pain group if they both responded (i) they generally had pain, according to Pre‐Sleep Questionnaire (PSQ) and (ii) their pain generally interfered with their sleep 3 or more times a week, according to Pittsburg Sleep Quality Index (PSQI). Those who answered negatively to both questions were allocated to the control group. All participants underwent a full night laboratory polysomnography, and completed questionnaires related to fatigue, depression, anxiety and quality of life. Results Pain group participants had a significantly lower perception of quality of life, and significantly higher levels of fatigue (5.4 times), anxiety and depression. Pain perception was also correlated to levels of anxiety and depression in the psychological (rs = −0.463, −0.607, respectively) and social (rs = −0.423, −0.438, respectively) quality of life domains. Conclusions Nighttime pain in women was associated with decreased quality of life, worsening mood and fatigue. Our data shows the importance of investigating pain and its deleterious effects on women's health. Significance Our study highlights that women experiencing nighttime pain also reported worse mood outcomes and decreased quality of life, regardless of the level and type of pain. Our data, based on association analysis and not investigating causality, suggest it is important to consider nighttime pain in clinical care to improve quality of life and general health.

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Major Depressive Disorder and Sleep Disturbance in Patients with Chronic Pain

Abstract: MDD in chronic pain may be related to the cognitive and behavioural aspects of insomnia, rather than to an incremental disturbance in the initiation or maintenance of sleep.

Cited by 51 publications

References 73 publications

Sleep Problems are Associated With Chronic Pain Over and Above Mutual Associations With Depression and Catastrophizing

Sleep Problems are Associated With Chronic Pain Over and Above Mutual Associations With Depression and Catastrophizing

The pain–depression dyad and the association with sleep dysfunction in chronic rhinosinusitis

Association between night pain and quality of life in women: A general population sleep study

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