Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway.
J Sleep Res. 2021 Aug;30(4):e13237. doi: 10.1111/jsr.13237. Epub 2021 Feb 2.
Patients with chronic pain commonly report sleep problems, and the evidence for a relationship between sleep disturbance and pain seems robust. The day-to-day associations between these constructs are less well studied, particularly with objective sleep measures such as actigraphy. Moreover, the concurrent presence of negative affective symptoms, as well as seasonality effects at extreme latitudes may complicate it further. Here, we studied 56 patients with chronic primary musculoskeletal pain conditions, contributing data in two separate 7-day data-collection periods during the summer and winter, respectively. The effect of self-reported sleep quality, and actigraphy measured sleep duration, efficiency and timing on next-day pain, as well as the effect of pain on the same sleep indices were estimated by generalised linear mixed regression models. The models were additionally adjusted for age, sex, education, data collection period, weekend, season and mental distress, with the latter two also specified as moderators. We observed a significant effect of pain as a predictor of next-night sleep quality (p = .003) and marginally of next-night sleep duration (p = .079). Conversely, sleep quality tentatively predicted next-day pain (p = .063). No other day-to-day associations were present. Mental distress was the strongest predictor of pain, but it did not modify the sleep-pain associations, nor did season. In conclusion pain, sleep quality and mental distress are closely related, underscoring the importance of encompassing this complexity in assessment and treatment of patients with chronic pain.
慢性疼痛患者常报告睡眠问题，而且睡眠障碍与疼痛之间的关系证据似乎很充分。这些结构之间的日常关联研究得较少，特别是使用客观的睡眠测量方法（如活动记录仪）时。此外，负面情感症状的同时存在以及极地处的季节性效应可能会使情况进一步复杂化。在这里，我们研究了 56 名患有慢性原发性肌肉骨骼疼痛的患者，他们分别在夏季和冬季的两个独立的 7 天数据收集期内提供数据。通过广义线性混合回归模型估计了自我报告的睡眠质量以及活动记录仪测量的睡眠持续时间、效率和时间对次日疼痛的影响，以及疼痛对同一睡眠指标的影响。这些模型还根据年龄、性别、教育程度、数据收集期、周末、季节和精神困扰进行了调整，后两者也被指定为调节剂。我们观察到疼痛作为次日睡眠质量（p=0.003）和睡眠持续时间（p=0.079）的预测因子具有显著影响。相反，睡眠质量勉强预测次日疼痛（p=0.063）。没有其他的日间关联。精神困扰是疼痛的最强预测因子，但它没有改变睡眠与疼痛的关联，季节也没有。总之，疼痛、睡眠质量和精神困扰密切相关，这突显了在评估和治疗慢性疼痛患者时包含这种复杂性的重要性。
