Poor Sleep Quality and Mood Disorders: Risk Factors of Increasing Chronic Pain in Patients with Insomnia.

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-06-23 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S518518

Liu Liu, Xianchao Zhao, Xinyan Zhang, Jiafeng Ren, Si Zeng, Yuee Dai, Wensheng Zhang, Junying Zhou

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引用次数: 0

Abstract

Objective: The aim of this study was to examine the prevalence of chronic pain and its risk factors in patients with insomnia.

Methods: We consecutively enrolled patients with chronic insomnia from Sleep Medicine Center in West China Hospital between May 2019 and February 2021. All patients were divided into two groups according to comorbid chronic pain or not. We used subjective questionnaires to assess sleep, daytime sleepiness, mood symptoms, and the characteristics and intensity of pain. Objective sleep quality was measured by polysomnography. The logistic regression analyses were used to identify the risk factors of chronic pain.

Results: Among 358 patients with chronic insomnia, 48.9% had chronic pain. These patients had significantly higher scores in Hamilton Rating Scale for Anxiety (HAMA), Hamilton Rating Scale for Depression (HAMD), Visual Analog Scale (VAS) and Short-Form McGill Pain Questionnaire (SF-MPQ) (all PS < 0.001) compared to those without chronic pain. After controlling for the confounding factors, higher HAMA scores adjusted odds ratio = 1.083, 95% CI 1.033-1.135, P = 0.001), higher HAMD scores (adjusted odds ratio = 1.109, 95% CI 1.058-1.163, P < 0.001) and shorter N3 sleep duration (adjusted odds ratio = 0.969, 95% CI 0.940-0.999, P = 0.041) were significantly associated with an increased risk of chronic pain. Multiple linear regression analyses showed that higher scores in Pittsburgh Sleep Quality Index (PSQI) (β = 0.108, 95% CI 0.026-0.191, P = 0.010), HAMA (β = 0.085, 95% CI 0.043-0.127, P < 0.001) and HAMD (β = 0.141, 95% CI 0.093-0.188, P < 0.001) were positively related to pain intensity.

Conclusion: Nearly half of patients with insomnia are comorbid with chronic pain. Poor subjective and objective sleep quality, as well as the anxious and depressive symptoms, are risk factors of chronic pain.

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睡眠质量差和情绪障碍：增加失眠患者慢性疼痛的危险因素。

目的：本研究旨在探讨失眠患者慢性疼痛的患病率及其危险因素。方法：我们连续招募2019年5月至2021年2月在华西医院睡眠医学中心就诊的慢性失眠症患者。所有患者根据是否合并慢性疼痛分为两组。我们使用主观问卷来评估睡眠、白天嗜睡、情绪症状以及疼痛的特征和强度。目的采用多导睡眠图测量睡眠质量。采用logistic回归分析确定慢性疼痛的危险因素。结果：358例慢性失眠患者中，48.9%存在慢性疼痛。这些患者在汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、视觉模拟量表（VAS）和短格式McGill疼痛问卷（SF-MPQ）中的得分均显著高于无慢性疼痛的患者（PS均< 0.001）。在控制混杂因素后，较高的HAMA评分校正优势比= 1.083,95% CI 1.033-1.135, P = 0.001)、较高的HAMD评分（校正优势比= 1.109,95% CI 1.058-1.163, P < 0.001）和较短的N3睡眠时间（校正优势比= 0.969,95% CI 0.940-0.999, P = 0.041）与慢性疼痛风险增加显著相关。多元线性回归分析显示，较高的匹兹堡睡眠质量指数（PSQI）（β = 0.108, 95% CI 0.026-0.191, P = 0.010）、HAMA （β = 0.085, 95% CI 0.043-0.127, P < 0.001）和HAMD （β = 0.141, 95% CI 0.093-0.188, P < 0.001）得分与疼痛程度呈正相关。结论：近一半的失眠患者伴有慢性疼痛。主观和客观睡眠质量差以及焦虑和抑郁症状是慢性疼痛的危险因素。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.