Lind Josefine, Andréll Paulin, Grimby-Ekman Anna
Chronic Pain, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden.
Department of Anaesthesiology and Intensive Care Medicine/Pain Centre, Sahlgrenska University Hospital, Region Västra Götaland, 416 50 Gothenburg, Sweden.
J Clin Med. 2021 Sep 7;10(18):4040. doi: 10.3390/jcm10184040.
Insomnia and chronic pain are prevalent health complaints. Previous research has shown that they are closely associated, but their interaction and causality are not completely understood. Further research is needed to uncover the extent to which a treatment strategy focusing on one of the conditions affects the other. This study aimed to map the prevalence of insomnia symptoms among patients in interdisciplinary pain rehabilitation program (IPRP) and investigate associations between the degree of insomnia at baseline and the treatment outcome regarding pain intensity, physical function, social function, mental well-being, anxiety, and depression. Of the 8515 patients with chronic pain, aged 15-81 who were registered in the Swedish Quality Registry for Pain Rehabilitation during 2016-2019 and participated in IPRP, 7261 had follow-up data after treatment. Logistic regression analysis was used to investigate associations. The prevalence of clinical insomnia, according to Insomnia Severity Index (ISI), among chronic pain patients in IPRP was 66%, and insomnia symptoms were associated with both country of birth and educational level. After IPRP, the prevalence of clinical insomnia decreased to 47%. There were statistically significant associations between the degree of insomnia symptoms before IPRP and physical function ( < 0.001), social function ( = 0.004) and mental well-being ( < 0.001). A higher degree of insomnia symptoms at baseline was associated with improvement after IPRP. In conclusion, IPRP seem to have beneficial effects on insomnia symptoms in chronic pain patients. Nevertheless, almost half of the patients still suffer from clinical insomnia after IPRP. The possible effect of systematic screening and treatment of insomnia for improving the effect of IPRP on pain is an important area for future research.
失眠和慢性疼痛是常见的健康问题。先前的研究表明它们密切相关,但它们之间的相互作用和因果关系尚未完全明了。需要进一步研究以揭示针对其中一种病症的治疗策略对另一种病症的影响程度。本研究旨在梳理跨学科疼痛康复项目(IPRP)中患者失眠症状的患病率,并调查基线时失眠程度与疼痛强度、身体功能、社会功能、心理健康、焦虑和抑郁方面治疗结果之间的关联。在2016年至2019年期间登记在瑞典疼痛康复质量登记处并参与IPRP的8515名15至81岁慢性疼痛患者中,7261名患者有治疗后的随访数据。采用逻辑回归分析来调查关联。根据失眠严重程度指数(ISI),IPRP中慢性疼痛患者临床失眠的患病率为66%,且失眠症状与出生国家和教育水平均有关联。IPRP治疗后,临床失眠的患病率降至47%。IPRP前失眠症状程度与身体功能(<0.001)、社会功能(=0.004)和心理健康(<0.001)之间存在统计学上的显著关联。基线时较高程度的失眠症状与IPRP治疗后的改善相关。总之,IPRP似乎对慢性疼痛患者的失眠症状有有益影响。然而,几乎一半的患者在IPRP治疗后仍患有临床失眠。系统筛查和治疗失眠对提高IPRP治疗疼痛效果的可能影响是未来研究的一个重要领域。