Pain Research Center, Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, United States.
Pain Research Center, Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, United States.
J Psychosom Res. 2019 Aug;123:109730. doi: 10.1016/j.jpsychores.2019.05.008. Epub 2019 May 22.
Discrepancies between self-reported and actigraphy sleep measures are common, producing ambiguity about which are better predictors of experimental pain outcomes. The current study tested if pain intensity during and situational pain catastrophizing following experimental pain were differentially predicted by self-reported or actigraphy sleep measures in patients with chronic temporomandibular disorder (TMJD) or healthy controls (HCs).
Forty patients with TMJD and 20 HCs completed self-report sleep measures (Pittsburgh Sleep Quality Index, PSQI; Insomnia Severity Index, ISI; PROMIS Sleep-Related Impairment [SRI] and Sleep Disruption [SD]), underwent an experimental pain induction consisting of four consecutive cold-water hand immersions, and provided pain intensity and situational pain catastrophizing ratings. Participants also wore an actigraphy watch and completed sleep diaries for seven days, which were averaged for actigraphic indices of total sleep time, sleep efficiency, wake after sleep onset, and self-reported sleep quality and restfulness.
Individuals with TMJD reported higher pain intensity during experimental pain (M = 65.81 vs. 47.77, p = .007) and self-reported worse sleep compared to HCs (all p's < 0.02, Cohen's D = 0.73-1.25). No group differences emerged for actigraphy measures (all p's > 0.05, Cohen's D = 0.05-0.53). Sleep variables did not interact with group to predict responses to experimental pain (all p's > 0.05). Across groups, PROMIS-SRI predicted pain intensity (β = 0.36, p = .008) and catastrophizing (β = 0.36, p = .009) after controlling for multiple comparisons, smoking, medications, and age.
Self-reported sleep (but not actigraphy) measures differentiate patients with TMJD from HCs. Sleep-related interference may place people at particular risk for higher pain intensity and catastrophizing following experimental pain.
自我报告和活动记录仪睡眠测量之间的差异很常见，这使得人们难以确定哪种测量结果更能预测实验性疼痛的结果。本研究测试了在患有慢性颞下颌关节紊乱症（TMD）或健康对照组（HC）的患者中，实验性疼痛期间和之后的疼痛强度以及情境性疼痛灾难化是否可以通过自我报告或活动记录仪睡眠测量来预测。
40 名 TMD 患者和 20 名 HC 完成了自我报告的睡眠测量（匹兹堡睡眠质量指数 [PSQI]；失眠严重程度指数 [ISI]；PROMIS 睡眠相关障碍 [SRI]和睡眠障碍 [SD]），进行了四次连续的冷水手部浸泡的实验性疼痛诱导，并提供了疼痛强度和情境性疼痛灾难化评分。参与者还佩戴了活动记录仪手表并填写了七天的睡眠日记，这些日记的平均值用于计算总睡眠时间、睡眠效率、睡眠后醒来时间以及自我报告的睡眠质量和休息感的活动记录仪指数。
TMD 患者报告在实验性疼痛期间的疼痛强度更高（M=65.81 与 47.77，p=0.007），并且自我报告的睡眠质量比 HC 差（所有 p 值均<0.02，Cohen's D=0.73-1.25）。活动记录仪测量值在两组之间没有差异（所有 p 值均>0.05，Cohen's D=0.05-0.53）。睡眠变量与组之间没有相互作用来预测对实验性疼痛的反应（所有 p 值均>0.05）。在两组中，PROMIS-SRI 预测了疼痛强度（β=0.36，p=0.008）和灾难化（β=0.36，p=0.009），在控制了多重比较、吸烟、药物和年龄后。
自我报告的睡眠（而不是活动记录仪）测量结果可将 TMD 患者与 HC 区分开来。睡眠相关的干扰可能使人们在经历实验性疼痛后面临更高的疼痛强度和灾难化的风险。
