Sleepiness comorbid to musculoskeletal pain is associated with worse quality of life and mood symptoms in a general population sample

Abstract

ObjectivesMusculoskeletal (MSK) pain and hypersomnolence (HPS) are very disabling conditions that may share some pathophysiological factors. This study aimed to evaluate the interaction between MSK pain and HPS and its association with mood symptoms, fatigue, quality of life, and both objective and subjective sleep quality.DesignCross-sectional study.SettingGeneral population based sample.Participants510 individuals from EPISONO cohort, São Paulo (Brazil).MeasurementsAll participants completed questionnaires, had clinical assessment and underwent a full-night polysomnography. HPS was defined according to Epworth Sleepiness Scale while the presence of MSK pain was defined by structured questionnaire. The sample was allocated into 4 groups: control (CTRL, n=281), HPS (n=141), MSK (n=50), and both conditions (HPS+MSK, n=38).ResultsMSK pain and HPS by themselves were associated with worse mood symptoms and quality of life. However, individuals with both associated conditions (HPS+MSK) presented higher frequencies of moderate to severe depression (44.1%) and anxiety symptoms (45.7%), as well as an additional decrease in quality of life compared to the other groups. There were no differences between HPS+MSK and MSK groups in objective sleep pattern. With regard to subjective sleep, HPS+MSK presented a higher prevalence of sleep attacks and cataplexy compared to all other groups.ConclusionsThe combination of MSK pain and HPS was associated with worse mood symptoms, quality of life and HPS-related features. This study suggests that sleepiness may be an important symptom to be investigated and treated in MSK pain-related conditions for a better quality of life.

Factors that influence the quality of life in neuropathic, musculoskeletal, and oncological pain

“…Such result reinforces the value and effectiveness of pharmacological therapy associated with the multiprofessional 19,25 . The prevalence of abnormal sleepiness was higher in subjects with musculoskeletal pain, however, contrary to what was proposed by the study 26 , the association of hypersomnia with this type of pain did not result in mood worsening. In contrast to another study 24 , although 77.27% of patients self-reported bad quality of sleep, it did not correlate with the intensity of pain mentioned by the patient.…”