Impact of Chronic Pain on Sleep Quality and its Association with Depression: A Multicentric Prospective Observational Study
DOI:
https://doi.org/10.37506/yfv4ms84Keywords:
Chronic pain, pain clinics, depression, sleep disturbance, quality of life, associationAbstract
Background: Chronic pain patients have been reported to complain about poor sleep quality and associated depression. Depressive mood and pain severity are the most frequently encountered predictors. The study was done to examine the impacts of chronic pain on depression and poor sleep quality dimensions. Materials & Methods:The study was a prospective, comparative, observational outcomes research study.The study was conducted at two dedicated pain clinics - one government and one private Pain Clinic in Kolkata; and one public routine health care facility.In the present study chronic pain related quality of life in health (patient’s mental status and pain disability) was assessed at baseline, during follow-up visit and end of the study.Association of depression, anxiety and sleep disturbances among chronic pain patients were also assessed. Results: Moderately severe depression was more prevalent in group 2 (15%), whereas moderate depression was more common in group 3 (40%) as compared to other groups. Severe depression was mainly absent in the majority of our study population except group 2 where 5% participants were assessed having severe depression. Sleep disturbances were more prevalent in group 3 patients (7.475 ± 2.0247) initially as compared to other groups. There was significant improvement in quality of sleep among all three groups (p<0.0001) after 6 months of treatment with most prominent improvement in group 3 patients (3.5 ± 1.7319).Conclusion:Chronic pain patients suffer from poor sleep quality—a function of depressed mood rather than pain intensity, duration, or anxiety. Future longitudinal studies with larger sample sizes are needed to confirm the mediating effect of poor sleep quality.
References
International Association for the Study of Pain Subcommittee on Taxonomy: Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Pain 1986; Suppl 3: S1 – S226.
Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al.. Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 2019; 160: 19–27.
McCormick T, Frampton C. Assessment of acute and chronic pain. Anaesthesia and Intensive Care Medicine 2019; 20: 405–409.
Kawai K, Kawai AT, Wollan P, Yawn BP. Adverse impacts of chronic pain on health-related quality of life, work productivity, depression and anxiety in a community-based study. FamPract 2017; 34: 656–661.
Alhalal EA, Alhalal IA, Alaida AM, Alhweity SM, Alshojaa AY, Alfaori AT. Effects of chronic pain on sleep quality and depression: A cross-sectional study. Saudi Med J. 2021 Mar;42(3):315-323.
Bond M. Pain education issues in developing countries and responses to them by the International Association for the Study of Pain. Pain Res Manag. 2011; 16:404–406.
Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006; 10:287–333.
Smith BH, Elliott AM, Chambers WA, Smith WC, Hannaford PC, Penny K. The impact of chronic pain in the community. FamPract. 2001; 18:292–299.
Lambert M. ICSI releases guideline on chronic pain assessment and management. Am Fam Physician. 2010; 82: 434–439.
International Association for the Study of Pain and delegates of International Pain Summit 2010: Declaration that Access to Pain Management Is a Fundamental Human Right, 2010. [http://www.iasppain.org/Content/NavigationMenu/Advocacy/DeclarationofMontr233al/default.htm; accessed 27 December 2013. Brennan F, Carr DB, Cousins M. Pain management: a fundamental human right. Pain Med 2007; 105:205–21.
Vas L. How to set up a pain clinic and practice as a pain management specialist. Indian J Anaesth.2006; 50 (5): 408 – 414.
Kerns RD, Turk DC, Rudy TE. The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain 1985; 23: 345–56.
Freynhagen R, Baron R, Gockel U, Tölle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006 Oct;22(10):1911-20. doi: 10.1185/030079906X132488. PMID: 17022849.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13.
Jenkins CD, Stanton BA, Niemcryk SJ, Rose RM. A scale for the estimation of sleep problems in clinical research. J Clin Epidemiol.1988; 41:313–321.
Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA. Studies with pain rating scales. Ann Rheum Dis 1978; 37:378–81.
Johnson C. Measuring pain. Visual analog scale versus numeric pain scale: what is the difference? J Chiropr Med 2005; 4:43–4.
Turk DC, Dworkin RH, Revicki D, et al. Identifying important outcome domains for chronic pain clinical trials: an IMMPACT survey of people with pain. Pain 2008; 137: 276–85.
Haack M, Scott-Sutherland J, Santangelo G, Simpson NS, Sethna N, Mullington JM. Pain sensitivity and modulation in primary insomnia. Eur J Pain 2012; 16:522–33.
Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, Khajehdehi A, Shapiro CM. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology 2008; 108:812–21.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.