Salvat F, Berrozpe E C, Pueyrredón H, Amuchastegui C, López V, Castrillo R, Alza F, Rivas R, Madrazo J, Mazzola M E, Lujan S, Farez M, Parada M
Fleni, Buenos Aires, Argentina.
Rev Neurol. 2023 May 1;76(9):287-293. doi: 10.33588/rn.7609.2023087.
Sleep disorders and chronic pain are linked to each other bidirectionally. Both are related to affective disorders, fatigue, depression, anxiety and drug abuse, and have a significant effect on quality of life. The Interdisciplinary Pain Programme (IDP) aims to relieve the patients' pain and improve their functionality by incorporating healthy postural, sleep and nutritional habits, relaxation techniques, physical exercise and cognitive-behavioural mechanisms.
A retrospective, observational, cross-sectional study was conducted. A total of 323 patients with chronic pain who completed the IDP were examined. They were assessed at the beginning and at the end of the programme with pain, depression, quality of life and insomnia scales, and were then compared between groups with and without insomnia, that is, with an insomnia severity index (ISI) less than 15 versus greater than or equal to 15. Fifty-eight patients were studied by means of polysomnography.
A significant improvement (p < 0.0001) in pain, depression and quality of life, as assessed by the visual analogue scale (VAS), the Beck inventory and the Short Form-36 (SF-36) questionnaire was observed in chronic pain patients with an ISI below 15 and in those with an ISI greater than or equal to 15. The results were superior in the group of patients with insomnia. The presence of a high apnoea and hypopnoea index and periodic lower limb movements in patients was not related to improvements on the Beck, SF-36, ISI and VAS scales.
In conclusion, IDP benefits patients with chronic non-cancer-induced pain in several affected areas, in addition to pain, due to a comprehensive treatment. Polysomnography can help diagnose specific pathologies and individualise pharmacological treatment.
睡眠障碍与慢性疼痛相互双向关联。两者均与情感障碍、疲劳、抑郁、焦虑及药物滥用有关，且对生活质量有显著影响。跨学科疼痛项目（IDP）旨在通过纳入健康的姿势、睡眠和营养习惯、放松技巧、体育锻炼及认知行为机制来缓解患者疼痛并改善其功能。
进行了一项回顾性、观察性横断面研究。共检查了323名完成IDP的慢性疼痛患者。在项目开始和结束时，使用疼痛、抑郁、生活质量和失眠量表对他们进行评估，然后比较失眠严重程度指数（ISI）小于15和大于或等于15的两组患者。通过多导睡眠图对58名患者进行了研究。
在ISI低于15以及ISI大于或等于15的慢性疼痛患者中，通过视觉模拟量表（VAS）、贝克量表和简短健康调查（SF - 36）问卷评估发现，疼痛、抑郁和生活质量有显著改善（p < 0.0001）。失眠患者组的结果更优。患者中高呼吸暂停和低通气指数以及周期性下肢运动的存在与贝克量表、SF - 36量表、ISI量表和VAS量表的改善无关。
总之，由于采用了综合治疗，IDP除了缓解疼痛外，还在多个受影响领域使慢性非癌症引起的疼痛患者受益。多导睡眠图有助于诊断特定病症并使药物治疗个体化。
