Sleep Impairment in Patients With Painful Diabetic Peripheral Neuropathy

Zelman, Diane C.; Brandenburg, Nancy A.; Gore, Mugdha

doi:10.1097/01.ajp.0000210910.49923.09

Cited by 157 publications

(70 citation statements)

References 34 publications

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“…Chronic pain is often associated with impaired sleep [44][45][46][47][48][49][50]. However, impaired sleep can also alter pain perception, which can heighten the perceived pain severity [51].…”

Section: Discussionmentioning

confidence: 99%

Improving sleep: Initial headache treatment in OIF/OEF veterans with blast-induced mild traumatic brain injury

Ruff¹,

Ruff²,

Wang³

2009

JRRD

102

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Abstract-This was an observational study of a cohort of 126 veterans with mild traumatic brain injury caused by an explosion during deployment in Operation Iraqi Freedom or Operation Enduring Freedom (OIF/OEF); 74 of the 126 veterans had comorbidities including frequent, severe headaches and residual deficits on neurological examination, neuropsychological testing, or both. Of these veterans, 71 had posttraumatic stress disorder and only 5 had restful sleep. We examined whether treatment with sleep hygiene counseling and oral prazosin would improve sleep, headaches, and cognitive performance. Nine weeks after providing sleep counseling and initiating an increasing dosage schedule of prazosin at bedtime, 65 veterans reported restful sleep. Peak headache pain (0-10 scale) decreased from 7.28 +/-0.27 to 4.08 +/-0.19 (values presented as mean +/-standard deviation). The number of headaches per month decreased from 12.40 +/-0.94 to 4.77 +/-0.34. Montreal Cognitive Assessment scores improved from 24.50 +/-0.49 to 28.60 +/-0.59. We found these gains maintained 6 months later. This pilot study suggests that addressing sleep is a good first step in treating posttraumatic headaches in OIF/OEF veterans.

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Section: Discussionmentioning

confidence: 99%

Improving sleep: Initial headache treatment in OIF/OEF veterans with blast-induced mild traumatic brain injury

Ruff¹,

Ruff²,

Wang³

2009

JRRD

102

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“…A nine-item Sleep Problems Index was calculated, and quantity of sleep was scored as the average hours of sleep per night reported over the past week. Sleep was scored as optimal in cases of 7-8 h of sleep per night (25,26).…”

Section: Outcome Measurementsmentioning

confidence: 99%

Spinal Cord Stimulation and Pain Relief in Painful Diabetic Peripheral Neuropathy: A Prospective Two-Center Randomized Controlled Trial

et al. 2014

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OBJECTIVEPainful diabetic peripheral neuropathy (PDPN) is a common complication of diabetes mellitus. Unfortunately, pharmacological treatment is often partially effective or accompanied by unacceptable side effects, and new treatments are urgently needed. Small observational studies suggested that spinal cord stimulation (SCS) may have positive effects. RESEARCH DESIGN AND METHODSWe performed a multicenter randomized clinical trial in 36 PDPN patients with severe lower limb pain not responding to conventional therapy. Twenty-two patients were randomly assigned to SCS in combination with the best medical treatment (BMT) (SCS group) and 14 to BMT only (BMT group). The SCS system was implanted only if trial stimulation was successful. Treatment success was defined as ‡50% pain relief during daytime or nighttime or "(very) much improved" for pain and sleep on the patient global impression of change (PGIC) scale at 6 months. RESULTSTrial stimulation was successful in 77% of the SCS patients. Treatment success was observed in 59% of the SCS and in 7% of the BMT patients (P < 0.01). Pain relief during daytime and during nighttime was reported by 41 and 36% in the SCS group and 0 and 7% in the BMT group, respectively (P < 0.05). Pain and sleep were "(very) much improved" in 55 and 36% in the SCS group, whereas no changes were seen in the BMT group, respectively (P < 0.001 and P < 0.05). One SCS patient died because of a subdural hematoma. CONCLUSIONSTreatment success was shown in 59% of patients with PDPN who were treated with SCS over a 6-month period, although this treatment is not without risks.Painful diabetic peripheral neuropathy (PDPN) is a common complication of diabetes mellitus (DM), and prevalence of PDPN ranges from 10 to 26% (1-3). In many patients, the pain is of such intensity that it has a major impact on patients' health-related quality of life (HRQoL) and functional ability, including interference with general activity, mood, mobility, work, social relations, sleep, and enjoyment of life (4).

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“…The MOS is a 12-item, self-report assessment of sleep functioning over the past month that has been used across a variety of clinical populations (Hays, Martin, Sesti, & Spritzer, 2005;Xu, Brandenburg, McDermott & Bazil, 2006;Zelman, Brandenburg & Gore, 2006). Items assessing sleep initiation (i.e., "How long did it usually take for you to fall asleep during the last month?")…”

Section: Medical Outcomes Study Sleep Questionnaire (Mos; Hays and Stewmentioning

confidence: 99%

Sleep problems reported by patients entering opioid agonist treatment

Burke

Peirce

Kidorf

et al. 2008

Journal of Substance Abuse Treatment

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Treatment-seeking opioid dependent individuals frequently report sleep-related problems (Dyer & White, 1997;Puigdollers et al., 2004). The present study provides a detailed assessment of sleep duration and quality in this population, including their effect on daily functioning and relationship to psychiatric severity and drug use. New admissions to opioid-agonist maintenance treatment (n = 113) completed a series of questionnaires to assess sleep functioning, psychiatric severity, and drug use due to sleep problems over the past 30-days. The results showed that study participants reported considerable sleep-related difficulties that had little effect on their appraisals of daily functioning. Nevertheless, sleep problems were associated with psychiatric distress, and those reporting substance use specifically to increase or decrease sleepiness endorsed more sleep problems and lower levels of daily functioning. Overall, these results replicate and extend previous work showing poor sleep functioning in this population, and show that sleep problems are associated with variables that often have an adverse impact on substance abuse treatment outcome.

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Sleep Impairment in Patients With Painful Diabetic Peripheral Neuropathy

Cited by 157 publications

References 34 publications

Improving sleep: Initial headache treatment in OIF/OEF veterans with blast-induced mild traumatic brain injury

Improving sleep: Initial headache treatment in OIF/OEF veterans with blast-induced mild traumatic brain injury

Spinal Cord Stimulation and Pain Relief in Painful Diabetic Peripheral Neuropathy: A Prospective Two-Center Randomized Controlled Trial

Sleep problems reported by patients entering opioid agonist treatment

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