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了解几组患有慢性疼痛的非肿瘤患者中情绪与睡眠障碍之间的不同关系。

Understanding the different relationships between mood and sleep disorders in several groups of non-oncological patients with chronic pain.

作者信息

Ojeda B, Salazar A, Calahorro M J, Dueñas M, Mico J A, de Sola H, Failde I

机构信息

a Preventive Medicine and Public Health Area , University of Cádiz , Spain.

b The Observatory of Pain (External Chair of Pain), University of Cádiz , Spain.

出版信息

Curr Med Res Opin. 2018 Apr;34(4):669-676. doi: 10.1080/03007995.2017.1384372. Epub 2017 Oct 25.

Abstract

OBJECTIVE

To compare sleep dimensions in patients suffering from chronic pain of different origins, and with a group of pain-free subjects. To analyze the relationship between depression and/or anxiety and sleep disorders in musculoskeletal, neuropathic, and fibromyalgia patients.

METHODS

This cross-sectional study included patients diagnosed with neuropathic pain (NP) (n = 104), musculoskeletal pain (MSK) (n = 99), or fibromyalgia (FM) (n = 51), and pain free subjects (n = 72). Information about sleep dimensions (MOS-sleep), duration and intensity of pain (Visual Analog Scale), and anxiety and depression (Hospital Anxiety and Depression scale) was collected.

RESULTS

Of the 254 patients with chronic pain (PCP) studied, the mean pain intensity was 6.6 (SD = 1.9), with an average duration of 9 years. The scores in all sleep dimensions of the MOS-sleep were higher in CPP (more disturbances) compared to pain free patients, and differences were observed among the three groups of PCP, with FM most severely affected. Anxiety (β = 1.3), depression (β = 1.1), intensity (β = 1.7), and duration of pain (β = 0.04) were associated with more sleep problems in MSK patients. In contrast, anxiety (β = 2.5) and duration of pain (β = 0.05) were negatively related to sleep in the NP patients, and only depression (β = 1.3) affected FM patients.

CONCLUSIONS

The sleep pattern differs among groups of PCP in the presence or absence of mood disorders. Understanding these disorders in each specific group of PCP is fundamental, and it can contribute to improve the clinical situation of the patients and better orientating therapeutic strategies.

摘要

目的

比较不同病因的慢性疼痛患者与无疼痛受试者的睡眠维度。分析肌肉骨骼疾病、神经病理性疼痛和纤维肌痛患者中抑郁和/或焦虑与睡眠障碍之间的关系。

方法

这项横断面研究纳入了被诊断为神经病理性疼痛(NP)(n = 104)、肌肉骨骼疼痛(MSK)(n = 99)或纤维肌痛(FM)(n = 51)的患者,以及无疼痛受试者(n = 72)。收集了有关睡眠维度(MOS-睡眠)、疼痛持续时间和强度(视觉模拟量表)以及焦虑和抑郁(医院焦虑抑郁量表)的信息。

结果

在研究的254例慢性疼痛患者(PCP)中,平均疼痛强度为6.6(标准差 = 1.9),平均病程为9年。与无疼痛患者相比,CPP患者(干扰更多)在MOS-睡眠的所有睡眠维度上得分更高,并且在三组PCP患者之间观察到差异,其中FM患者受影响最严重。焦虑(β = 1.3)、抑郁(β = 1.1)、疼痛强度(β = 1.7)和疼痛持续时间(β = 0.04)与MSK患者更多的睡眠问题相关。相比之下,焦虑(β = 2.5)和疼痛持续时间(β = 0.05)与NP患者的睡眠呈负相关,并且只有抑郁(β = 1.3)影响FM患者。

结论

在有或无情绪障碍的情况下,PCP患者组之间的睡眠模式不同。了解每个特定PCP患者组中的这些障碍至关重要,这有助于改善患者的临床状况并更好地指导治疗策略。

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