Vellucci Renato, De Rosa Gianluca, Piraccini Emanuele
University of Florence, Pain and Palliative Care Clinic, University Hospital of Careggi, Florence, Italy.
Department of Medicine, Grünenthal Italy, Milan, Italy.
Drugs Context. 2021 Apr 19;10. doi: 10.7573/dic.2020-12-9. eCollection 2021.
Poor sleep may predict the increase and intensification of pain over time with increased insomnia symptoms being both a predictor and an indicator of worse pain outcomes and physical functioning status over time. However, the impact of different analgesic therapies on quality of life, functional recovery and sleep has been poorly assessed to date, whereas these evaluations may greatly help clinicians in the selection of treatment when dealing with patients with chronic pain (CP).
To explore whether tapentadol-induced pain relief may drive improved sleep quality, we carried out a pooled analysis of real-world data collected from 487 patients with CP (mean age, 68.3 years; 57.7% women) suffering from a wide range of chronic musculoskeletal pain conditions and treated with tapentadol.
Following tapentadol treatment, patients experienced an 80% reduction in the frequency of very disturbed sleep as well as a 50% reduction in the predominant sleep complaint reported by patients with CP - that is, nocturnal awakenings. A significantly greater proportion of patients reported good/restful sleep at the end of the study period compared to baseline (72.4% 25.3%; <0.01). This benefit was observed regardless of the clinical setting, treatment duration, posology or patient age and was associated with a higher proportion of patients reporting an improved global health status and good tolerability.
The reduction in pain intensity provided by tapentadol fosters sleep quality and favours a better quality of life. Therefore, our findings provide the rationale for addressing sleep quality as a relevant outcome, complementary to pain relief in CP management.
睡眠不佳可能预示着疼痛会随着时间的推移而增加和加剧，失眠症状的加重既是疼痛恶化结果和身体功能状态的预测指标，也是其指示指标。然而，迄今为止，不同镇痛疗法对生活质量、功能恢复和睡眠的影响评估不足，而这些评估可能极大地帮助临床医生在治疗慢性疼痛（CP）患者时选择治疗方法。
为了探究曲马多缓释片缓解疼痛是否能改善睡眠质量，我们对487例CP患者（平均年龄68.3岁；57.7%为女性）的真实世界数据进行了汇总分析，这些患者患有多种慢性肌肉骨骼疼痛疾病，并接受曲马多缓释片治疗。
曲马多缓释片治疗后，患者睡眠严重受干扰的频率降低了80%，CP患者报告的主要睡眠问题——夜间觉醒减少了50%。与基线相比，在研究期末报告睡眠良好/安稳的患者比例显著更高（72.4%对25.3%；<0.01）。无论临床情况、治疗持续时间、用药剂量或患者年龄如何，均观察到这种益处，并且报告整体健康状况改善和耐受性良好的患者比例更高。
曲马多缓释片减轻疼痛强度可促进睡眠质量，有利于提高生活质量。因此，我们的研究结果为将睡眠质量作为一个相关结果进行评估提供了理论依据，这是CP管理中疼痛缓解的补充。
