Alföldi Peter, Wiklund Tobias, Gerdle Björn
Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Rehabilitation Medicine, University of Linköping , Linköping , Sweden and.
Disabil Rehabil. 2014;36(20):1661-9. doi: 10.3109/09638288.2013.864712. Epub 2013 Dec 9.
This study investigates the prevalence of insomnia and its relationship to other symptoms and health aspects in patients with chronic pain.
Patients with chronic pain conditions (n = 845) referred to a multidisciplinary pain centre completed surveys provided by the Swedish quality registry for pain rehabilitation (SQRP). The SQRP collects data on socio-demographics, health status, symptoms of pain, mood and insomnia and life satisfaction.
The majority of patients (65.3%) had clinical insomnia according to the insomnia severity index (ISI). Insomnia correlated significantly but weakly with pain, depression, anxiety and coping; the strongest multivariate correlations were found with depression and anxiety followed by pain interference and pain severity. Pain intensity, depression and anxiety correlated stronger than ISI with respect to the two investigated aspects of health.
The prevalence of insomnia is high in patients with chronic pain conditions, but the level of importance in relation to other symptoms for health aspects is low, and the associations with other important symptoms are relatively weak. One way to increase the effects of multimodal rehabilitation programs may be to provide interventions directed specifically at insomnia rather than focusing only on interventions that address pain, depression and anxiety. Implications for Rehabilitation The prevalence of insomnia is high in patients with complex chronic pain conditions. Relatively low correlations existed between insomnia and pain intensity, depression, anxiety and other psychological aspects. Pain intensity, anxiety and depression were more important for perceived health aspects than insomnia. One way to increase the effects of multimodal rehabilitation programs may be to also include interventions directed directly to insomnia.
本研究调查慢性疼痛患者中失眠的患病率及其与其他症状和健康状况的关系。
转诊至多学科疼痛中心的慢性疼痛患者（n = 845）完成了瑞典疼痛康复质量登记处（SQRP）提供的调查问卷。SQRP收集社会人口统计学、健康状况、疼痛症状、情绪、失眠和生活满意度的数据。
根据失眠严重程度指数（ISI），大多数患者（65.3%）患有临床失眠。失眠与疼痛、抑郁、焦虑和应对方式显著但微弱相关；与抑郁和焦虑的多变量相关性最强，其次是疼痛干扰和疼痛严重程度。就所调查的两个健康方面而言，疼痛强度、抑郁和焦虑与ISI的相关性更强。
慢性疼痛患者中失眠的患病率较高，但与其他健康方面症状相比，其重要性水平较低，且与其他重要症状的关联相对较弱。提高多模式康复计划效果的一种方法可能是提供专门针对失眠的干预措施，而不是仅专注于解决疼痛、抑郁和焦虑的干预措施。
复杂慢性疼痛患者中失眠的患病率较高。失眠与疼痛强度、抑郁、焦虑和其他心理方面的相关性相对较低。对于感知到的健康方面，疼痛强度、焦虑和抑郁比失眠更重要。提高多模式康复计划效果的一种方法可能是也包括直接针对失眠的干预措施。
