Sachau Juliane, Kersebaum Dilara, Hüllemann Philipp, Adolf Daniela, Kabelitz Maria, Keller Thomas, Freynhagen Rainer, Tölle Thomas R, Binder Andreas, Baron Ralf
Division of Pain Research and Therapy, Department of Neurology, University Hospital Kiel, Schleswig-Holstein, Kiel, Germany.
Schön Clinic Rendsburg, Department of Psychiatry, Psychotherapy and Psychosomatics, Rendsburg, Germany.
Pain Rep. 2023 Sep 26;8(5):e1098. doi: 10.1097/PR9.0000000000001098. eCollection 2023 Sep.
Patients with neuropathic pain (NP) report a higher impairment of quality of life and sleep than patients with chronic pain without neuropathic characteristics. These include somatosensory peculiarities like allodynia, a surrogate marker for central sensitization.
This study aimed to investigate the relation between symptoms of central sensitization and sleep disturbances in patients with NP.
Within this cross-sectional study, data sets of 3339 patients with chronic NP syndromes (painful diabetic polyneuropathy, n = 543; postherpetic neuralgia, n = 1480) or complex regional pain syndromes (CRPS, n = 1316) were analyzed. Neuropathic pain symptoms were assessed with the painDETECT questionnaire (PD-Q), depression with the Patient Health Questionnaire-9, and sleep impairment with items of the Medical Outcomes Study Sleep Scale in 4 subscales. The association of demographic/clinical data, somatosensory phenotype, depression, and pain intensity with sleep impairment was assessed by unadjusted Spearman correlation analyses and multivariable regression analyses.
Sleep impairment was observed in all pain aetiologies although with some significant differences in the single sleep items. The intensity of the individual PD-Q items differed to some extent between the 3 pain entities, whereas the PD-Q sum score was similar. Thermal hyperalgesia and burning assessed by the PD-Q were significantly associated with sleep disturbance, adequacy, and quantity but not with sleep somnolence. Only depression and self-reported allodynia had a significant relation to all 4 sleep elements.
Beside depression, allodynia as a surrogate marker hints to a possible impact of central sensitization on the sleep disruption of patients with NP.
与无神经病理性特征的慢性疼痛患者相比，神经病理性疼痛（NP）患者报告的生活质量和睡眠受损程度更高。这些包括如痛觉过敏等躯体感觉异常，是中枢敏化的替代标志物。
本研究旨在调查NP患者中枢敏化症状与睡眠障碍之间的关系。
在这项横断面研究中，分析了3339例慢性NP综合征（疼痛性糖尿病性多发性神经病，n = 543；带状疱疹后神经痛，n = 1480）或复杂性区域疼痛综合征（CRPS，n = 1316）患者的数据集。使用疼痛DETECT问卷（PD-Q）评估神经病理性疼痛症状，使用患者健康问卷-9评估抑郁，使用医学结局研究睡眠量表的项目在4个分量表中评估睡眠障碍。通过未调整的Spearman相关分析和多变量回归分析评估人口统计学/临床数据、躯体感觉表型、抑郁和疼痛强度与睡眠障碍的关联。
在所有疼痛病因中均观察到睡眠障碍，尽管单个睡眠项目存在一些显著差异。3种疼痛类型之间，各个PD-Q项目的强度在一定程度上有所不同，而PD-Q总分相似。PD-Q评估的热痛觉过敏和灼痛与睡眠障碍、充足度和时长显著相关，但与睡眠嗜睡无关。只有抑郁和自我报告的痛觉过敏与所有4个睡眠要素有显著关系。
除抑郁外，作为替代标志物的痛觉过敏提示中枢敏化可能对NP患者的睡眠中断有影响。
