McHugh R Kathryn, Edwards Robert R, Ross Edgar L, Jamison Robert N
Division of Alcohol and Drug Abuse, Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA.
Department of Anesthesiology, Pain Management Center, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Pain Rep. 2019 May 9;4(3):e747. doi: 10.1097/PR9.0000000000000747. eCollection 2019 May-Jun.
Chronic pain patients frequently report having sleep disturbances and many tend to stay up during the night and then sleep into the day.
This study was designed to compare a heterogeneous group of persons with chronic pain who reported typically going to bed between the hours of 9 pm and midnight with those who go to bed at other hours of the day and night.
Two hundred seventy-nine participants were divided between those who reported going to bed between the hours of 9 pm and midnight (N = 205) and those who reported having atypical bedtimes (N = 74) based on pre-post questionnaire data and average pain assessments from a smartphone pain application (app).
Those individuals in the atypical bedtime group reported waking up more frequently and getting fewer hours sleep ( < 0.05). These individuals also reported significantly higher pain scores, activity interference, and taking more prescription opioid medication compared with those who had typical bedtimes ( < 0.05). Based on average 3-month daily assessments, those subjects with an atypical bedtime consistently reported more sleep disturbances, pain, activity interference, negative mood, and general worsening conditions over time, and elevated pain catastrophizing, pain-related disability, emotional distress scores, and more prescription medication for pain at 3-month follow-up ( < 0.01).
These results support the importance of providers asking patients with pain about what time they typically go to bed at night to gain a greater understanding of their lifestyle habits. Future studies are needed to further determine the importance of maintaining a typical bedtime among patients with chronic pain.
慢性疼痛患者经常报告存在睡眠障碍，许多人倾向于夜间熬夜，然后白天睡觉。
本研究旨在比较一组异质性的慢性疼痛患者，其中一部分患者报告通常在晚上9点至午夜之间上床睡觉，另一部分患者在白天或晚上的其他时间上床睡觉。
根据前后问卷调查数据以及智能手机疼痛应用程序（应用）的平均疼痛评估，将279名参与者分为两组，一组报告在晚上9点至午夜之间上床睡觉（N = 205），另一组报告有非典型就寝时间（N = 74）。
非典型就寝时间组的个体报告醒来更频繁，睡眠时间更少（P < 0.05）。与有典型就寝时间的个体相比，这些个体还报告疼痛评分、活动干扰显著更高，服用的处方阿片类药物更多（P < 0.05）。基于平均3个月的每日评估，随着时间的推移，那些有非典型就寝时间的受试者持续报告更多的睡眠障碍、疼痛、活动干扰、负面情绪和总体病情恶化，并且在3个月随访时疼痛灾难化、疼痛相关残疾、情绪困扰评分升高，用于止痛的处方药更多（P < 0.01）。
这些结果支持医疗服务提供者询问疼痛患者他们通常晚上上床睡觉的时间，以更好地了解他们的生活方式习惯的重要性。未来需要进一步研究以确定维持典型就寝时间对慢性疼痛患者的重要性。
