老年人睡眠困难相关慢性疼痛的特征：老年人平衡、独立生活、智力和热情维持（MOBILIZE）波士顿研究。
Characteristics of chronic pain associated with sleep difficulty in older adults: the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston study.
机构信息
College of Nursing and Health Sciences, University of Massachusetts Boston, Massachusetts, USA.
出版信息
J Am Geriatr Soc. 2011 Aug;59(8):1385-92. doi: 10.1111/j.1532-5415.2011.03544.x. Epub 2011 Aug 1.
OBJECTIVES
To evaluate pain severity and distribution in relation to sleep difficulty in older adults.
DESIGN
Population-based cross-sectional study.
SETTING
Community within a 5-mile radius of the study center at the Institute for Aging Research, Hebrew SeniorLife (HSL), Boston.
PARTICIPANTS
Seven hundred sixty-five participants of the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston Study aged 64 and older.
MEASUREMENTS
Pain severity was measured using the Brief Pain Inventory (BPI) Pain Severity Subscale. Musculoskeletal pain distribution was grouped according to no pain, single site, two or more sites, and widespread pain (upper and lower extremities and back pain). Three aspects of sleep difficulty were measured using items from the Center for Epidemiologic Studies Depression Scale, Revised (trouble getting to sleep, sleep more than usual, and restless sleep).
RESULTS
Prevalence of trouble getting to sleep according to BPI severity was 17.8%, 19.7%, 32.0%, and 37.0% for the lowest to highest pain severity quartiles, respectively. Similar relationships between pain and sleep were observed across sleep measures according to pain severity and distribution. Adjusted for sociodemographic characteristics, chronic conditions, and health behaviors, chronic pain was strongly associated with trouble sleeping (≥ 1 d/wk) (single-site pain, odds ratio (OR)=1.77, 95% confidence interval (CI)=1.10-2.87; multisite pain, OR=2.38, 95% CI=1.48-3.83; widespread pain, OR=2.55, 95% CI=1.43-4.54, each compared with no pain). Similar associations were observed for restless sleep and sleeping more than usual. For specific pain sites alone or in combination with other sites of pain, only modest associations were observed with sleep problems.
CONCLUSION
Widespread or other multisite pain and moderate to severe pain are strongly associated with sleep difficulty in older adults. Further research is needed to better understand the burden and consequences of pain-related sleep problems in older adults.
目的
评估老年人疼痛严重程度和分布与睡眠困难的关系。
设计
基于人群的横断面研究。
地点
研究中心位于波士顿希伯来长寿研究所（HSL）的研究中心周围 5 英里范围内的社区。
参与者
参与波士顿维持平衡、独立生活、智力和老年人活力（MOBILIZE）研究的 765 名年龄在 64 岁及以上的老年人。
测量方法
疼痛严重程度使用简明疼痛量表（BPI）疼痛严重程度子量表进行测量。肌肉骨骼疼痛分布根据无疼痛、单个部位、两个或多个部位以及广泛疼痛（上下肢和背痛）进行分组。使用来自修订后的流行病学研究中心抑郁量表（CES-D-R）的项目测量睡眠困难的三个方面，包括入睡困难、睡眠过多和睡眠不安。
结果
根据 BPI 严重程度，入睡困难的发生率分别为最低至最高疼痛严重程度四分位数的 17.8%、19.7%、32.0%和 37.0%。在根据疼痛严重程度和分布测量的睡眠指标中，观察到类似的疼痛与睡眠之间的关系。在调整了社会人口统计学特征、慢性疾病和健康行为后，慢性疼痛与睡眠困难（每周≥1 天）密切相关（单部位疼痛，优势比（OR）=1.77，95%置信区间（CI）=1.10-2.87；多部位疼痛，OR=2.38，95%CI=1.48-3.83；广泛疼痛，OR=2.55，95%CI=1.43-4.54，与无疼痛相比，每个疼痛部位）。对于睡眠不安和睡眠过多，也观察到类似的关联。对于特定的疼痛部位或与其他疼痛部位结合，仅观察到与睡眠问题的适度关联。
结论
广泛或其他多部位疼痛以及中度至重度疼痛与老年人睡眠困难密切相关。需要进一步研究以更好地了解老年人与疼痛相关的睡眠问题的负担和后果。
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