Institute for Global Health, UCL, London, United Kingdom.
Health Protection Research Unit (HPRU), National Institute for Health Research (NIHR), Blood-Borne and Sexually Transmitted Infections, UCL in Partnership with Public Health England (PHE).
J Acquir Immune Defic Syndr. 2020 Sep 1;85(1):106-112. doi: 10.1097/QAI.0000000000002410.
We investigate the association of widespread pain with sleep quality among people with HIV and HIV-negative controls.
UK-based cohort.
Pain information was collected through a pain mannikin identifying affected body sites; pain was classified as widespread if pain was reported in ≥4 of 5 body regions and in ≥7 of 15 body sites, and as regional otherwise. Sleep was assessed a median of 3.2 years later through 7-night actigraphy and through self-reported assessments of sleep quality. Chi-squared tests, Kruskal-Wallis tests, and linear/logistic regression considered associations between pain extent and sleep quality.
Of the 414 participants, 74 (17.9%) reported widespread and 189 (45.7%) regional pain. Although there were few clear associations between actigraphy outcomes and pain extent, those with widespread and regional pain consistently reported poorer sleep quality on all self-reported measures than those with no pain. Median (interquartile range) insomnia severity index and Patient-reported Outcomes Measurement Information System (PROMIS) for sleep disturbance and sleep-related impairment scores were 12 (7-16), 55.3 (48.0-58.9), and 57.2 (48.9-61.3), respectively, for those with widespread pain, 8 (4-13), 51.2 (45.5-58.3), and 50.3 (43.6-56.1) for those with regional pain, and 5 (2-9), 47.9 (42.9-54.3), and 45.5 (41.4-50.3) for those with no pain (all P values 0.0001). Associations remained strong after adjustment for HIV status and other confounders, and were reduced but remained significant, after adjustment for depressive symptoms.
Widespread pain was not associated with objective measures of sleep but was strongly associated with self-reported assessments of sleep quality in people with HIV.
我们研究了广泛疼痛与 HIV 感染者和 HIV 阴性对照者睡眠质量之间的关系。
英国队列。
通过疼痛人体模型收集疼痛信息，以确定受影响的身体部位；如果报告的疼痛发生在≥5 个身体区域中的≥4 个，或发生在≥15 个身体部位中的≥7 个，则将疼痛分类为广泛疼痛，否则为局部疼痛。中位数为 3.2 年后，通过 7 夜活动记录仪和自我报告的睡眠质量评估来评估睡眠。卡方检验、克鲁斯卡尔-沃利斯检验和线性/逻辑回归考虑了疼痛程度与睡眠质量之间的关系。
在 414 名参与者中，74 名（17.9%）报告了广泛疼痛，189 名（45.7%）报告了局部疼痛。尽管活动记录仪结果与疼痛程度之间几乎没有明确的关联，但那些有广泛和局部疼痛的人在所有自我报告的测量中都报告了较差的睡眠质量，而那些没有疼痛的人则报告了较差的睡眠质量。广泛疼痛者的中位（四分位距）失眠严重指数和患者报告的结局测量信息系统（PROMIS）睡眠障碍和睡眠相关损害评分分别为 12（7-16）、55.3（48.0-58.9）和 57.2（48.9-61.3），局部疼痛者分别为 8（4-13）、51.2（45.5-58.3）和 50.3（43.6-56.1），无疼痛者分别为 5（2-9）、47.9（42.9-54.3）和 45.5（41.4-50.3）（所有 P 值均<0.0001）。在调整了 HIV 状态和其他混杂因素后，这些关联仍然很强，在调整了抑郁症状后，这些关联虽然减弱但仍然显著。
广泛疼痛与客观睡眠测量无关，但与 HIV 感染者的自我报告睡眠质量评估密切相关。
