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Bouchachi FZ, Al Wachami N, Arraji M, Boumendil K, Iderdar Y, Aquil A, El Got A, Chahboune M. Chronic Pain Characteristics and Interference With Daily Activities in Patients Undergoing Hemodialysis: A Cross-Sectional Study. Pain Manag Nurs 2025:S1524-9042(25)00151-1. [PMID: 40318955 DOI: 10.1016/j.pmn.2025.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 03/11/2025] [Accepted: 03/29/2025] [Indexed: 05/07/2025]
Abstract
PURPOSE Few studies have analyzed the characteristics of chronic pain and its functional interference. This study aims to measure the prevalence of pain and assess the intensity, location, treatments used and functional interference in the daily living of patients with chronic pain undergoing hemodialysis treatments in Morocco. DESIGN This research has a descriptive cross-sectional design METHODS: A multicenter study was performed in four public hemodialysis centers in Morocco's northern region including 174 patients undergoing hemodialysis. Sociodemographic, chronic pain and interference were evaluated through a structured questionnaire, the Visual Analog Scale and the Brief Pain Inventory. RESULTS Descriptive statistics were applied to data analysis. The prevalence of chronic pain was 56.7%, severe in 50.6% of cases and 81.6% experienced continuous pain. The most common pain locations among patients undergoing hemodialysis were the lower limbs 58.6%, back 41.4% and hips 36.4%. Therefore, a high prevalence of severe functional interference of pain has been found in walking 60.34%, general activities 52.87% and work 48.85%. Additionally, analgesics were used by 73.6% of patients, with 46.1% of instances involving frequent use and relief for 32.81%. CONCLUSIONS Chronic pain is prevalent, undertreated and localized in the lower limbs, back and hips, leading to severe interference with functional activities. CLINICAL IMPLICATIONS This evidence makes professionals aware of their patient's pain and its impact, and consequently, their assessment must be conducted in a primordial and regular manner to improve management. Pain management can be based on pharmacological approaches such as opioids as well as nonpharmacological approaches.
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Affiliation(s)
- Fatima Zahra Bouchachi
- Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco.
| | - Nadia Al Wachami
- Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Maryem Arraji
- Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Karima Boumendil
- Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Younes Iderdar
- Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Amina Aquil
- Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Abdeljalil El Got
- Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Mohamed Chahboune
- Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
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López-Monzoni S, Hernando Benito G, Romero-Peralta S, Silgado-Martínez L, Viejo-Ayuso ME, Álvarez-Balado L, Rodríguez Matarranz E, Forné Izquierdo C, Sánchez-de-la-Torre M, Masa JF, Barbé F, García-Río F, Martínez-Nicolás A, García-Mediano B, Solano-Pérez E, Mediano O. Improving Anxiety Related to Chronic Pain Through a Sleep Circadian Intervention Program: A Pilot Study. Behav Sci (Basel) 2025; 15:40. [PMID: 39851844 PMCID: PMC11762505 DOI: 10.3390/bs15010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 12/27/2024] [Accepted: 12/30/2024] [Indexed: 01/26/2025] Open
Abstract
The limitations of pharmacological treatments for chronic pain have become increasingly evident: dependency, side effects, resistance, and diminishing efficacy. The urgent need for innovative solutions has become a compelling focus for improving patient outcomes. Innovative non-pharmacological approaches, such as sleep management, as a strategy to reduce opioid consumption and pain control are needed. The aim was to evaluate the impact of a Sleep and Circadian Intervention Program (SCIP) in the control of chronic musculoskeletal pain (CMP). This was a randomized clinical trial (NCT03646084), in which 49 CMP patients were assigned to SCIP (n = 15, mean age 51 years and 40% women) or non-SCIP groups (n = 26, 53 years and 61.5% women). Outcomes were evaluated after 6 months through self-reported questionnaires (pain intensity, physical function, depression/anxiety, and quality of life (QoL)). The SCIP group was assessed by polysomnography and specific questionnaires and was treated for diagnosed sleep disorders according to clinical guidelines. This population showed a moderate pain intensity at baseline, important deterioration of QoL and pathological anxiety/fear related to pain. Fifty percent of them presented restless leg syndrome, 60% moderate/severe insomnia, and 62.5% sleep apnea. During the follow-up, the SCIP group presented a greater reduction in the abnormal risk group for anxiety (from 73.3% to 46.7%) and depression (from 53.3% to 33.3%) on the Hospital Anxiety and Depression Scale compared to the non-SCIP group (from 40% to 29.2% and 33.3% to 29.2%, respectively). Also, a positive significant effect on anxiety/fear related to pain was found in the Pain Anxiety Symptoms Scale multivariable model, with an important improvement in symptoms. The application of SCIP in CMP patients improved anxiety and controlled associated sleep disorders, highlighting the impact on insomnia. Larger studies are needed for better understanding of the sleep intervention in CMP control.
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Affiliation(s)
- Sonia López-Monzoni
- Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (S.L.-M.); (S.R.-P.); (M.E.V.-A.); (L.Á.-B.); (B.G.-M.)
- Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla La Mancha (IDISCAM), 45071 Toledo, Spain
| | - Gloria Hernando Benito
- Medicine Department, Universidad de Alcalá, 28805 Madrid, Spain;
- Internal Medicine Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain
| | - Sofía Romero-Peralta
- Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (S.L.-M.); (S.R.-P.); (M.E.V.-A.); (L.Á.-B.); (B.G.-M.)
- Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla La Mancha (IDISCAM), 45071 Toledo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
| | - Laura Silgado-Martínez
- Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (S.L.-M.); (S.R.-P.); (M.E.V.-A.); (L.Á.-B.); (B.G.-M.)
- Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla La Mancha (IDISCAM), 45071 Toledo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
| | - Maria Esther Viejo-Ayuso
- Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (S.L.-M.); (S.R.-P.); (M.E.V.-A.); (L.Á.-B.); (B.G.-M.)
- Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla La Mancha (IDISCAM), 45071 Toledo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
| | - Leticia Álvarez-Balado
- Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (S.L.-M.); (S.R.-P.); (M.E.V.-A.); (L.Á.-B.); (B.G.-M.)
- Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla La Mancha (IDISCAM), 45071 Toledo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
| | | | - Carles Forné Izquierdo
- Heorfy Consulting, 25007 Lleida, Spain;
- Department of Basic Medical Sciences, Universitat de Lleida, 25198 Lleida, Spain
| | - Manuel Sánchez-de-la-Torre
- Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla La Mancha (IDISCAM), 45071 Toledo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, Universidad de Castilla la Mancha, 45071 Toledo, Spain
| | - Juan Fernando Masa
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
- Respiratory Department, Hospital Universitario San Pedro Alcántara, 10003 Cáceres, Spain
| | - Ferrán Barbé
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), 25198 Lleida, Spain
| | - Francisco García-Río
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
- Medicine Department, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Respiratory Department, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPaz), 28046 Madrid, Spain
| | - Antonio Martínez-Nicolás
- Chronobiology Lab, Department of Physiology, College of Biology, Universidad de Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, 30100 Murcia, Spain;
- Human Physiology Area, Faculty of Sport Sciences, Universidad de Murcia, Santiago de La Ribera-San Javier, 30720 Murcia, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28029 Madrid, Spain
| | - Belén García-Mediano
- Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (S.L.-M.); (S.R.-P.); (M.E.V.-A.); (L.Á.-B.); (B.G.-M.)
| | - Esther Solano-Pérez
- Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (S.L.-M.); (S.R.-P.); (M.E.V.-A.); (L.Á.-B.); (B.G.-M.)
- Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla La Mancha (IDISCAM), 45071 Toledo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
| | - Olga Mediano
- Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (S.L.-M.); (S.R.-P.); (M.E.V.-A.); (L.Á.-B.); (B.G.-M.)
- Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla La Mancha (IDISCAM), 45071 Toledo, Spain
- Internal Medicine Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (J.F.M.); (F.B.); (F.G.-R.)
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Zhang Y, Xu Y, Cao Z, Zhang Y, Yang Y, Li J, Ding X, Hu F, Ma J. Analysis of the factors influencing of sleep quality in intensive care unit awake patients based on a structural equation model: A cross-sectional study. J Clin Nurs 2025; 34:171-184. [PMID: 38797951 DOI: 10.1111/jocn.17311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 05/13/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE The objective of this study was to construct and validate a structural equation model (SEM) to identify factors associated with sleep quality in awake patients in the intensive care unit (ICU) and to assist in the development of clinical intervention strategies. RESEARCH METHODS/SETTING In this cross-sectional study, 200 awake patients who were cared for in the ICU of a tertiary hospital in China were surveyed via several self-report questionnaires and wearable actigraphy sleep monitoring devices. Based on the collected data, structural equation modelling analysis was performed using SPSS and AMOS statistical analysis software. The study is reported using the STROBE checklist. RESULTS The fit indices of the SEM were acceptable: χ2/df = 1.676 (p < .001) and RMSEA = .058 (p < 0.080). Anxiety/depression had a direct negative effect on the sleep quality of awake patients cared for in the ICU (β = -.440, p < .001). In addition, disease-freeness progress had an indirect negative effect on the sleep quality of awake patients cared for in the ICU (β = -.142, p < .001). Analgesics had an indirect negative effect on the sleep quality of awake patients cared for in the ICU through pain and sedatives (β = -.082, p < .001). Sedation had a direct positive effect on the sleep quality of conscious patients cared for in the ICU (β = .493; p < .001). CONCLUSION The results of the SEM showed that the sleep quality of awake patients cared for in the ICU is mainly affected by psychological and disease-related factors, especially anxiety, depression and pain, so we can improve the sleep quality of patients through psychological intervention and drug intervention.
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Affiliation(s)
- Yanting Zhang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Ying Xu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Zheng Cao
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Yuan Zhang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Yihua Yang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Jin Li
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Xinbo Ding
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Fen Hu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Jing Ma
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
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Salazar-Méndez J, Viscay-Sanhueza N, Pinto-Vera C, Oyarce-Contreras F, Parra-Vera MF, Suso-Martí L, Guzmán-Muñoz E, López-Bueno R, Núñez-Cortés R, Calatayud J. Cognitive behavioral therapy for insomnia in people with chronic musculoskeletal pain. A systematic review and dose-response meta-analysis. Sleep Med 2024; 122:20-26. [PMID: 39111059 DOI: 10.1016/j.sleep.2024.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 09/12/2024]
Abstract
The aims were (i) to determine the effects of Cognitive behavioral therapy for insomnia (CBT-I) on sleep disturbances, pain intensity and disability in patients with chronic musculoskeletal pain (CMP), and (ii) to determine the dose-response association between CBT-I dose (total minutes) and improvements in sleep disorders, pain intensity and disability in patients with CMP. A comprehensive search was conducted in PubMed/MEDLINE, Web of Science, CINAHL, and SCOPUS until December 17, 2023. Randomized clinical trials (RCTs) using CBT-I without co-interventions in people with CMP and sleep disorders were eligible. Two reviewers independently extracted data and assessed risk of bias and certainty of the evidence. A random effects meta-analysis was applied to determine the effects on the variables of interest. The dose-response association was assessed using a restricted cubic spline model. Eleven RCTs (n = 1801 participants) were included. We found a significant effect in favor of CBT-I for insomnia (SMD: -1.34; 95%CI: -2.12 to -0.56), with a peak effect size at 450 min of CBT-I (-1.65, 95%CI: -1.89 to -1.40). A non-significant effect was found for pain intensity. A meta-analysis of disability was not possible due to the lack of data. This review found benefits of CBT-I for insomnia compared to control interventions, with a large effect size. In addition, it was estimated that a 250-min dose of CBT-I had a large effect on reducing insomnia and that the peak effect was reached at 450 min. These novel findings may guide clinicians in optimizing the use of CBT-I in people with CMP and insomnia.
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Affiliation(s)
- Joaquín Salazar-Méndez
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile; Laboratorio de Investigación Somatosensorial y Motora, Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | - Nelson Viscay-Sanhueza
- Unidad de Medicina Física y Rehabilitación, Hospital Dr. Gustavo Fricke, Viña del Mar, Chile
| | - Catalina Pinto-Vera
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | | | | | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Eduardo Guzmán-Muñoz
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | - Rubén López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark
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Mann C, Staubach P. [Quality of life and sleep quality in patients with chronic pruritus]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:612-616. [PMID: 38914832 DOI: 10.1007/s00105-024-05373-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/26/2024]
Abstract
Pruritus is defined as a symptom that leads to scratching. Clinically, a heterogeneous group of clinical pictures of different etiology must be considered. Pruritus is characterized by varying intensity and duration. Many patients and/or their social environment, which is influenced by this, cite the impact on sleep quality as an accompanying main symptom. The patient's quality of life is affected depending on the severity of the pruritus and often leads to comorbidity such as depressive disorders or sleep disorders as well as to an impact on psychosocial well-being if it becomes chronic. To date, in addition to the medical history, the established examination methods have been the determination of the disease burden by assessing disease activity, e.g., with validated disease-specific scores, plus the assessment of quality of life using a dermatological quality of life index (DLQI). The latest studies show that this is by no means sufficient to determine the severity of disease and, as a result, to identify adequate treatment options.
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Affiliation(s)
- Caroline Mann
- Haut- und Poliklinik der Johannes Gutenberg Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Petra Staubach
- Haut- und Poliklinik der Johannes Gutenberg Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
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Singh S, Kapoor S. Managing patients' pain while preserving sleep quality and efficiency. Evid Based Nurs 2024; 27:92. [PMID: 37709364 DOI: 10.1136/ebnurs-2023-103704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Shaminder Singh
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada
| | - Sumeeta Kapoor
- Anesthesia, Alberta Health Services, Calgary, Alberta, Canada
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Park JY, Kim MS, Ryu JM. Predictors of sleep quality components in patients undergoing transarterial chemoembolisation: a cross-sectional study. Support Care Cancer 2024; 32:149. [PMID: 38329591 DOI: 10.1007/s00520-024-08338-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/20/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Patients undergoing transarterial chemoembolisation experience postembolisation symptoms and interferences affecting sleep quality, which require intervention. The study aimed to identify the predictors of sleep quality components in patients undergoing transarterial chemoembolisation. METHODS This study included two groups of participants: 50 patients undergoing transarterial chemoembolisation and 45 nurses caring for them. Data were collected from September to November 2022 using a structured questionnaire, and analysed using descriptive statistics, the t-test, analysis of variance, Spearman's rank correlation, and multiple regression analysis using the SPSS 27.0 program (IBM Corp., Armonk, NY, USA). RESULTS The mean sleep quality score was 40.28±14.10. Heat sensation (t=-2.08, p=.043) and fatigue (t=-4.47, p<.001) predicted sleep fragmentation in 38.6% of the patients. Abdominal pain (t=-2.54, p=.014), vomiting (t=-2.21, p=.032), and the expected fatigue by the nurses (t=2.68, p=.014) predicted sleep length in 41.7% of patients. Abdominal pain (t=-2.05, p=.046) explained 42.9% of sleep depth. CONCLUSION Based on the predictors of sleep quality components obtained in this study, strategies to improve sleep quality tailored to patients undergoing transarterial chemoembolisation should be developed. This study highlighted the need to bridge the gap between patients' and nurses' expected fatigue and its contribution to sleep fragmentation and sleep length. It also highlighted the importance of noncontact temperature measurement, controlling vomiting, and pain relief for improving sleep length in patients undergoing transarterial chemoembolisation.
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Affiliation(s)
- Ji Young Park
- Gastrointestinal Surgery Ward, Pusan National University Hospital, Busan, South Korea
| | - Myoung Soo Kim
- Department of Nursing, Pukyong National University, 599-1, Daeyeon 3 dong, Namgu, Busan, 48513, South Korea.
| | - Jung Mi Ryu
- Department of Nursing, Busan Institute of Science and Technology, Busan, South Korea
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Menés Fernández L, Salvat I, Adillón C. Expressed Beliefs about the Cause of Pain in a Pediatric Population: A Qualitative Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1007. [PMID: 37371238 DOI: 10.3390/children10061007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/28/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
(1) Background: The aims of this study are to explore what beliefs children and adolescents manifest about the cause of the pain they describe, to compare whether there are differences between beliefs by age and the persistence of pain, and to relate the explanations of the cause of pain with current scientific evidence. (2) Methods: a cross-sectional qualitative study was used. The primary endpoint of the study was obtaining explanations of the cause of pain recorded by means of an open-ended question. The participants were school-age children attending a charted school in the province of Barcelona. (3) Results: The children and adolescents proposed a diverse range of explanations for the cause of pain that they reported in their responses. The most frequent explanation for the cause of pain were pathologies and injuries (45.95%), ergonomic issues (22.60%) and psychological issues (15.95%). (4) Conclusions: There is a lot of variety in the explanations that young people give about the cause of their pain in schoolchildren aged between 10 and 16 years old. There exists a high prevalence of explanations non-associated with tissue damage (ENAD) concerning the causes of pain described. It is necessary that future health prevention programs dedicated to early ages consider which beliefs about the cause of pain are the most frequent in the pediatric population.
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Affiliation(s)
- Laura Menés Fernández
- Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, 43204 Reus, Spain
| | - Isabel Salvat
- Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, 43204 Reus, Spain
| | - Cristina Adillón
- Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, 43204 Reus, Spain
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Gupta CC, Sprajcer M, Johnston-Devin C, Ferguson SA. Sleep hygiene strategies for individuals with chronic pain: a scoping review. BMJ Open 2023; 13:e060401. [PMID: 36731933 PMCID: PMC9896248 DOI: 10.1136/bmjopen-2021-060401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/07/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Up to a quarter of the world's population experience chronic pain, which, in addition to interfering with daily activities and waking function, is often associated with poor sleep. Individuals experiencing poor sleep are often encouraged to implement sleep hygiene strategies. However, current sleep hygiene strategies have not been developed considering the unique challenges faced by individuals with chronic pain and therefore they might not be as effective in this population. The aim of this scoping review is to map the state of the existing literature examining sleep hygiene strategies in individuals with chronic pain. DESIGN This scoping review included a search of four online databases (Medline, Embase, PsycINFO and CINAHL) to identify articles examining the use of sleep hygiene strategies in populations with chronic pain. RESULTS Thirty articles investigated at least one sleep hygiene strategy in individuals with chronic pain, with improvements to sleep reported for six sleep hygiene strategies (education, exercise, limiting alcohol use, limiting tobacco use, prebed state and sleep environment). However, the timing of these strategies was often not reported which limits the degree to which these strategies can be generalised for use as a presleep strategy. CONCLUSION This scoping review examined the existing literature focusing on sleep hygiene strategies for people with chronic pain. There are limitations to the methodology of the existing literature and gaps in our understanding of sleep hygiene strategies in some chronic pain conditions that must be addressed in future research before the effectiveness of these strategies can be understood.
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Affiliation(s)
- Charlotte C Gupta
- Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
| | - Madeline Sprajcer
- Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
| | - Colleen Johnston-Devin
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Sally A Ferguson
- Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
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10
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Bonin EAC, Lejeune N, Szymkowicz E, Bonhomme V, Martial C, Gosseries O, Laureys S, Thibaut A. Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review. Front Syst Neurosci 2023; 17:1112206. [PMID: 37021037 PMCID: PMC10067681 DOI: 10.3389/fnsys.2023.1112206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/06/2023] [Indexed: 04/07/2023] Open
Abstract
The assessment and management of pain and nociception is very challenging in patients unable to communicate functionally such as patients with disorders of consciousness (DoC) or in locked-in syndrome (LIS). In a clinical setting, the detection of signs of pain and nociception by the medical staff is therefore essential for the wellbeing and management of these patients. However, there is still a lot unknown and a lack of clear guidelines regarding the assessment, management and treatment of pain and nociception in these populations. The purpose of this narrative review is to examine the current knowledge regarding this issue by covering different topics such as: the neurophysiology of pain and nociception (in healthy subjects and patients), the source and impact of nociception and pain in DoC and LIS and, finally, the assessment and treatment of pain and nociception in these populations. In this review we will also give possible research directions that could help to improve the management of this specific population of severely brain damaged patients.
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Affiliation(s)
- Estelle A. C. Bonin
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
| | - Nicolas Lejeune
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre Hospitalier Neurologique (CHN) William Lennox, Saint-Luc Hospital Group, Ottignies-Louvain-la-Neuve, Belgium
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Emilie Szymkowicz
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
| | - Vincent Bonhomme
- Department of Anesthesia and Intensive Care Medicine, Liège University Hospital, Liège, Belgium
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSS), University Laval, Québec City, QC, Canada
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
- *Correspondence: Aurore Thibaut,
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11
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Pain and Analgesic related insomnia. Pain Manag Nurs 2022; 24:254-264. [DOI: 10.1016/j.pmn.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/11/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022]
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12
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Peterson A, Schaller AS. How Hospital Patients Experience Pain the Previous 24 Hours-A Prevalence Assessment of Pain in Five Hospitals in Sweden. Pain Manag Nurs 2022; 23:878-884. [PMID: 36075787 DOI: 10.1016/j.pmn.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 06/23/2022] [Accepted: 07/17/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Previous studies show that pain is common among hospital inpatients. AIM This study measures the prevalence of pain and the impact of pain on sleep in patients admitted to five hospitals in Sweden. METHODS The patients were admitted to a surgical or a medical ward. They answered on a self-reported questionnaire about their average pain intensity and how much their pain interfered with their sleep the previous 24 hours, on a 010 numerical rating scale (NRS). RESULTS Of the 500 patients, 308 experienced pain (62%), (NRS ≥ 3) and 111 (22%) rated their pain as NRS ≥ 7. We found no difference between surgical and medical specialty regarding pain prevalence. The results suggest that roughly the same proportion of patients with pain also experienced poor sleep due to pain265 patients (53%) reported pain interference on sleep, NRS ≥ 3. CONCLUSIONS AND CLINICAL IMPLICATIONS This study shows that there is still an unacceptable high pain prevalence in inpatients and that patients experience pain as negatively impacting their sleep. Future pain care is likely to include a more comprehensive implementation strategy for the dissemination of knowledge, especially related to the complex context of today's healthcare system. That is, the possibility that anchoring new knowledge also benefits the patient is probably associated with optimization of the structural context. Future research should take this question further by examining how the organizational structure should be optimized for the dissemination of knowledge in healthcare professionals about pain and pain interference with sleep.
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Affiliation(s)
- Anna Peterson
- ain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Anne Söderlund Schaller
- ain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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13
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Berro LF, Zamarripa CA, Talley JT, Freeman KB, Rowlett JK. Effects of methadone, buprenorphine, and naltrexone on actigraphy-based sleep-like parameters in male rhesus monkeys. Addict Behav 2022; 135:107433. [PMID: 35901553 PMCID: PMC9495253 DOI: 10.1016/j.addbeh.2022.107433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 06/28/2022] [Accepted: 07/15/2022] [Indexed: 11/01/2022]
Abstract
Opioid use disorder (OUD) has been associated with the emergence of sleep disturbances. Although effective treatments for OUD exist, evidence suggests that these treatments also may be associated with sleep impairment. The extent to which these effects are an effect of OUD treatment or a result of chronic opioid use remains unknown. We investigated the acute effects of methadone, buprenorphine, and naltrexone on actigraphy-based sleep-like parameters in non-opioid-dependent male rhesus monkeys (Macaca mulatta, n = 5). Subjects were fitted with actigraphy monitors attached to primate collars to measure sleep-like parameters. Actigraphy recordings were conducted under baseline conditions, or following acute injections of vehicle, methadone (0.03-1.0 mg/kg, i.m.), buprenorphine (0.01-1.0 mg/kg, i.m.), or naltrexone (0.03-1.0 mg/kg, i.m.) in the morning (4 h after "lights on") or in the evening (1.5 h before "lights off"). Morning and evening treatments with methadone or buprenorphine significantly increased sleep latency and decreased sleep efficiency. The effects of buprenorphine on sleep-like measures resulted in a biphasic dose-response function, with the highest doses not disrupting actigraphy-based sleep. Buprenorphine induced a much more robust increase in sleep latency and decrease in sleep efficiency compared to methadone, particularly with evening administration, and detrimental effects of buprenorphine on sleep-like measures were observed up to 25.5 h after drug injection. Treatment with naltrexone, on the other hand, significantly improved sleep-like measures, with evening treatments improving both sleep latency and sleep efficiency. The currently available pharmacotherapies for OUD significantly alter sleep-like parameters in non-opioid-dependent monkeys, and opioid-dependent mechanisms may play a significant role in sleep-wake regulation.
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Affiliation(s)
- Lais F Berro
- Department of Psychiatry & Human Behavior, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, USA.
| | - C Austin Zamarripa
- Department of Psychiatry & Human Behavior, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, USA
| | - Joseph T Talley
- Department of Psychiatry & Human Behavior, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, USA
| | - Kevin B Freeman
- Department of Psychiatry & Human Behavior, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, USA
| | - James K Rowlett
- Department of Psychiatry & Human Behavior, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, USA
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14
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Adamo D, Calabria E, Coppola N, Lo Muzio L, Giuliani M, Azzi L, Maurino V, Colella G, Rauso R, Montebugnoli L, Gissi DB, Gabriele M, Nisi M, Sardella A, Lodi G, Varoni EM, Giudice A, Antonelli A, Cabras M, Gambino A, Vescovi P, Majorana A, Bardellini E, Campisi G, Panzarella V, Spadari F, Marino S, Pentenero M, Sutera S, Biasotto M, Gobbo M, Guarda Nardini L, Romeo U, Tenore G, Serpico R, Lucchese A, Lajolo C, Rupe C, Aria M, Gnasso A, Mignogna MD. Assessment of sleep disturbance in oral lichen planus and validation of PSQI: A case-control multicenter study from the SIPMO (Italian Society of Oral Pathology and Medicine). J Oral Pathol Med 2022; 51:194-205. [PMID: 34704302 DOI: 10.1111/jop.13255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/29/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The wellbeing of oral lichen planus patients (OLPs) may be strongly influenced by a poor quality of sleep (QoS) and psychological impairment. The aims were to analyze the prevalence of sleep disturbance, anxiety, and depression in OLPs and to validate the Pittsburgh Sleep Quality Index (PSQI) in OLPs. METHODS Three hundred keratotic OLPs (K-OLPs), 300 with predominant non-keratotic OLP (nK-OLPs), and 300 controls were recruited in 15 Italian universities. The PSQI, Epworth Sleepiness Scale (ESS), Hamilton Rating Scales for Depression and Anxiety (HAM-D and HAM-A), Numeric Rating Scale (NRS), and Total Pain Rating Index (T-PRI) were administered. RESULTS Oral lichen planus patients had statistically higher scores than the controls in the majority of the PSQI sub-items (p-values < 0.001**). Moreover, OLPs had higher scores in the HAM-D, HAM-A, NRS, and T-PRI (p-values < 0.001**). No differences in the PSQI sub-items' scores were found between the K-OLPs and nK-OLPs, although nK-OLPs suffered from higher levels of anxiety, depression, and pain (p-values: HAM-A, 0.007**, HAM-D, 0.009**, NRS, <0.001**, T-PRI, <0.001**). The female gender, anxiety, depression (p-value: 0.007**, 0.001**, 0.020*) and the intensity of pain, anxiety, and depression (p-value: 0.006**, <0.001**, 0.014*) were independent predictors of poor sleep (PSQI > 5) in K-OLPs and nK-OLPs, respectively. The PSQI's validation demonstrated good internal consistency and reliability of both the total and subscale of the PSQI. CONCLUSIONS The OLPs reported an overall impaired QoS, which seemed to be an independent parameter according to the regression analysis. Hence, clinicians should assess QoS in OLPs and treat sleep disturbances in order to improve OLPs management.
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Affiliation(s)
- Daniela Adamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elena Calabria
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Noemi Coppola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Michele Giuliani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lorenzo Azzi
- Department of Medicine and Surgery, Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, University of Insubria, Varese, Italy
| | - Vittorio Maurino
- Department of Medicine and Surgery, Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, University of Insubria, Varese, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Raffaele Rauso
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Lucio Montebugnoli
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Davide Bartolomeo Gissi
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Mario Gabriele
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Marco Nisi
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Andrea Sardella
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Giovanni Lodi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Elena Maria Varoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Amerigo Giudice
- Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Alessandro Antonelli
- Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Marco Cabras
- Oral Medicine Section, Department of Surgical Science, CIR Dental School, University of Turin, Turin, Italy
| | - Alessio Gambino
- Oral Medicine Section, Department of Surgical Science, CIR Dental School, University of Turin, Turin, Italy
| | - Paolo Vescovi
- Department of Medicine and Surgery, Oral Medicine and Laser Surgery Unit, University Center of Dentistry, University of Parma, Parma, Italy
| | - Alessandra Majorana
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Elena Bardellini
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Vera Panzarella
- Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Francesco Spadari
- Department of Biomedical, Surgical and Dental Sciences, Maxillo-facial and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan, Milan, Italy
| | - Sonia Marino
- Department of Biomedical, Surgical and Dental Sciences, Maxillo-facial and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan, Milan, Italy
| | - Monica Pentenero
- Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy
| | - Samuele Sutera
- Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy
| | - Matteo Biasotto
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Margherita Gobbo
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Treviso, Italy
| | - Luca Guarda Nardini
- Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Treviso, Italy
| | - Umberto Romeo
- Department of Oral Sciences and Maxillofacial Surgery, University of Rome La Sapienza, Rome, Italy
| | - Gianluca Tenore
- Department of Oral Sciences and Maxillofacial Surgery, University of Rome La Sapienza, Rome, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alberta Lucchese
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Carlo Lajolo
- Head and Neck Department, School of Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cosimo Rupe
- Head and Neck Department, School of Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, Naples, Italy
| | - Agostino Gnasso
- Department of Economics and Statistics, University Federico II of Naples, Naples, Italy
| | - Michele Davide Mignogna
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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15
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Aldabbas MM, Tanwar T, Ghrouz A, Iram I, Warren Spence D, Pandi-Perumal SR, Veqar Z. A polysomnographic study of sleep disruptions in individuals with chronic neck pain. J Sleep Res 2022; 31:e13549. [PMID: 35044011 DOI: 10.1111/jsr.13549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/31/2021] [Accepted: 01/02/2022] [Indexed: 11/27/2022]
Abstract
Various lines of evidence suggest that a bidirectional relationship exists between poor sleep quality and chronic pain, with each condition tending to promote and exacerbate the other. This has led to the hypothesis that the two conditions may be linked by common underlying mechanisms. It has thus been suggested that inadequate sleep and chronic pain may share neurophysiological and molecular pathways that are similar or overlapping. Some studies based on self-report measures have tended to support the inference that chronic neck pain may promote sleep disturbance, but this association has not, until now, been investigated with quantitative measures. The present study is the first to evaluate the sleep quality of patients with chronic neck pain through the use of polysomnography. The study sought to identify the sleep characteristics of patients with chronic neck pain and then to determine whether these characteristics were associated with the severity of their neck pain. Laboratory testing with polysomnography was carried out on 32 males who had complaints of chronic neck pain and on 12 healthy participants who served as controls. Compared to the control subjects, patients with chronic neck pain were found to have significantly shorter times spent in sleep (p = 0.015), longer latencies to sleep onset (p = 0.015) and rapid eye movement (REM) sleep (p < 0.05), longer durations spent in Stage 1 (p < 0.05), and shorter durations spent in both Stage 2 (p = 0.001) and REM sleep (p = 0.00). The severity of discomfort was related negatively to the amount of time spent in REM sleep. The present study's quantitative measures corroborate the view that patients with chronic neck pain have poor sleep quality. These findings confirm long-held clinical observations that the sleep quality of patients with chronic neck pain is compromised, and that, in this clinical group, poor sleep is at least a correlate of and may be an amplifier of perceived pain.
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Affiliation(s)
- Mosab M Aldabbas
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia Central University, New Delhi, India
| | - Tarushi Tanwar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia Central University, New Delhi, India
| | - Amer Ghrouz
- Department of Applied Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Iram Iram
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia Central University, New Delhi, India
| | | | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., Toronto, Ontario, Canada.,Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia Central University, New Delhi, India
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16
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Zambelli Z, Jakobsson CE, Threadgold L, Fidalgo AR, Halstead EJ, Dimitriou D. Exploring the feasibility and acceptability of a sleep wearable headband among a community sample of chronic pain individuals: An at-home observational study. Digit Health 2022; 8:20552076221097504. [PMID: 35574578 PMCID: PMC9102155 DOI: 10.1177/20552076221097504] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/29/2022] [Accepted: 04/12/2022] [Indexed: 11/22/2022] Open
Abstract
Background Chronic pain conditions affect up to one third of the adult population in the United Kingdom. Sleep problems are prevalent and negatively impact quality of life. Lack of standardised tools for routine screening and assessment of sleep changes have been a barrier for sleep management. Novel sleep wearables offer an exciting and accessible way to measure sleep but have not been tested outside of the consumer-led landscape and are not commonly used in research and clinical settings. Aims The study aimed to explore the feasibility and acceptability of a sleep monitoring headband (Dreem 2) utilising EEG technology and accompanying smartphone application among a cohort of adults with chronic pain. Results Twenty-one adults (81% women) completed a one-week home sleep study using a sleep headband and accompanying app. Ninety per cent of participants met the pre-defined requirement of two-night's sleep recording. All participants recorded one night of sleep data via the sleep headband. The majority (76%) of participants were satisfied with the sleep study, and 86% of participants were willing to wear the headband longer than the 2-night minimum requirement. Finally, 76% reported the headband as 'somewhat' or 'extremely' comfortable whist awake; 57% rated the headband as comfortable during sleep. Conclusion The Dreem 2 headband appears to be a feasible and acceptable means of collecting sleep measurements among individuals with chronic pain, despite common sleep disturbances. These devices may have utility for screening, assessment and monitoring in research and practice. Further research is needed to provide guidelines and training for integration.
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Affiliation(s)
- Zoe Zambelli
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, WC1H 0AA, UK
| | - Cecilia E. Jakobsson
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, WC1H 0AA, UK
| | - Laura Threadgold
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, WC1H 0AA, UK
| | | | - Elizabeth J. Halstead
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, WC1H 0AA, UK
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, WC1H 0AA, UK
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17
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Alhendi F, Ko E, Graham L, Corby P. The association of sleep disturbances with burning mouth syndrome: An overlooked relationship-A qualitative systematic review. Oral Dis 2021; 29:6-20. [PMID: 34657343 DOI: 10.1111/odi.14051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/07/2021] [Accepted: 10/10/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To review the relevant literature to assess whether patients with burning mouth syndrome (BMS) are more prone to have sleep disturbances than general population. METHODS The literature search for relevant articles was from July 2020 to March 2021. A systematic search of PubMed, Embase, Google Scholar, Cochrane library, Dentistry & Oral Sciences Source, and Scopus was conducted to search for relevant studies. The quality of studies was assessed in accordance with the Joanna Briggs Institute's guidelines and using the software SUMARI-The System for the Unified Management, Assessment and Review of Information. Confidence in the findings was assessed using the GRADE-CERQual approach. RESULTS A total of 1064 studies were initially identified from the search; six studies, two cross-sectional and four case-control, met the inclusion criteria and were selected for this systematic review. Sleep disturbances were a required outcome measured in selected studies evaluating symptoms of BMS. For studies that were included in the final analyses, BMS was found to relate to several dimensions of sleep including sleep disturbance and duration (n = 6), sleep affecting daytime function (n = 4), sleep quality (n = 6), sleep efficiency (n = 4), and ability to fall asleep (n = 4). Consistent evidence of moderate confidence found that BMS was associated with greater sleep disturbance, reduced sleep quality, increased time taken to fall asleep, reduced sleep efficiency, and poor daytime function, whereas evidence of low confidence was found regarding the association of BMS with reduced sleep duration. CONCLUSIONS Although the presented studies could not establish a direct causal relationship between BMS and sleep disturbances, it supports the evidence that sleep disturbance is associated with symptoms of BMS. Management strategies to improve sleep may be considered in future research for managing BMS patients.
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Affiliation(s)
- Fatmah Alhendi
- Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eugene Ko
- Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laurel Graham
- Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Patricia Corby
- Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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18
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Christopher SM, Cook CE, Snodgrass SJ. What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool. PLoS One 2021; 16:e0255383. [PMID: 34383792 PMCID: PMC8360599 DOI: 10.1371/journal.pone.0255383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/14/2021] [Indexed: 01/29/2023] Open
Abstract
Background In 2019, a majority of runners participating in running events were female and 49% were of childbearing age. Studies have reported that women are initiating or returning to running after childbirth with up to 35% reporting pain. There are no studies exploring running-related pain or risk factors for this pain after childbirth in runners. Postpartum runners have a variety of biomechanical, musculoskeletal, and physiologic impairments from which to recover from when returning to high impact sports like running, which could influence initiating or returning to running. Therefore, the purpose of this study was to identify risk factors associated with running-related pain in postpartum runners with and without pain. This study also aimed to understand the compounding effects of multiple associative risk factors by developing a clinical decision tool to identify postpartum runners at higher risk for pain. Methods Postpartum runners with at least one child ≤36 months who ran once a week and postpartum runners unable to run because of pain, but identified as runners, were surveyed. Running variables (mileage, time to first postpartum run), postpartum variables (delivery type, breastfeeding, incontinence, sleep, fatigue, depression), and demographic information were collected. Risk factors for running-related pain were analyzed in bivariate regression models. Variables meeting criteria (P<0.15) were entered into a multivariate logistic regression model to create a clinical decision tool. The tool identified compounding factors that increased the probability of having running-related pain after childbirth. Results Analyses included 538 postpartum runners; 176 (32.7%) reporting running-related pain. Eleven variables were included in the multivariate model with six retained in the clinical decision tool: runner type-novice (OR 3.51; 95% CI 1.65, 7.48), postpartum accumulated fatigue score of >19 (OR 2.48; 95% CI 1.44, 4.28), previous running injury (OR 1.95; 95% CI 1.31, 2.91), vaginal delivery (OR 1.63; 95% CI 1.06, 2.50), incontinence (OR 1.95; 95% CI 1.31, 2.84) and <6.8 hours of sleep on average per night (OR 1.89; 95% CI 1.28, 2.78). Having ≥ 4 risk factors increased the probability of having running-related pain to 61.2%. Conclusion The results of this study provide a deeper understanding of the risk factors for running-related pain in postpartum runners. With this information, clinicians can monitor and educate postpartum runners initiating or returning to running. Education could include details of risk factors, combinations of factors for pain and strategies to mitigate risks. Coaches can adapt running workload accounting for fatigue and sleep fluctuations to optimize recovery and performance. Future longitudinal studies that follow asymptomatic postpartum women returning to running after childbirth over time should be performed to validate these findings.
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Affiliation(s)
- Shefali Mathur Christopher
- Department of Physical Therapy Education, Elon University, Elon, NC, United States of America
- Discipline of Physiotherapy, School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
- * E-mail:
| | - Chad E. Cook
- Doctor of Physical Therapy Division, Department of Orthopaedics, Duke University School of Medicine, Durham, NC, United States of America
- Duke Clinical Research Institute, Duke University, Durham, NC, United States of America
- Duke Department of Population Health Sciences, Durham, NC, United States of America
| | - Suzanne J. Snodgrass
- Discipline of Physiotherapy, School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
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19
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Hao X, Li M, Li J, Lv M, Qin Y, Li K. Sleep quality in relation to social support and resilience among rural empty-nest older adults in China. Sleep Med 2021; 82:193-199. [PMID: 33957415 DOI: 10.1016/j.sleep.2021.03.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/12/2021] [Accepted: 03/26/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Population ageing is a global problem, and one of the adverse effects in China is the rural empty-nest phenomenon, which is increasingly prominent. Recently, the sleep problems of rural empty nesters have gradually aroused attention. The purpose of this article was to investigate sleep quality and its influencing factors in rural empty nesters and explore the correlation between social support, resilience and sleep quality in the target population. METHODS This study investigated 250 empty nesters in six rural areas. Information on sociodemographics, sleep quality, social support and resilience was collected. Univariate analysis and multivariate analysis were used to determine the influencing factors of sleep quality. The Spearman correlation coefficient was used to evaluate the linear associations between social support, resilience and sleep quality. The mediating effect of resilience between social support and sleep quality was measured by bootstrap-mediated analysis. RESULTS The sleep quality score among rural empty nesters was 6.74 ± 3.80. Sleep quality was influenced significantly by marital status, monthly income, number of chronic diseases and frequency of communication with children. Besides, social support and resilience were significantly positively correlated with sleep quality. Resilience was not the only mediating variable between social support and sleep quality. CONCLUSION The sleep quality of rural empty nesters was poorer than those of the general rural older adults and affected by multiple factors. Moreover, social support and resilience had a positive impact on the sleep quality of rural empty nesters, which provided new ideas for exploring specific measures to improve their sleep quality in the future.
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Affiliation(s)
- Xiaonan Hao
- School of Nursing, Jilin University, Changchun 130021, China.
| | - Manman Li
- The Third Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Jing Li
- School of Nursing, Jilin University, Changchun 130021, China.
| | - Miaohua Lv
- School of Nursing, Jilin University, Changchun 130021, China.
| | - Yuan Qin
- School of Nursing, Jilin University, Changchun 130021, China.
| | - Kun Li
- School of Nursing, Jilin University, Changchun 130021, China.
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20
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Lapane KL, Shridharmurthy D, Harkey MS, Driban JB, Dubé CE, Liu SH. The relationship between restless sleep and symptoms of the knee: data from the Osteoarthritis Initiative. Clin Rheumatol 2021; 40:2167-2175. [PMID: 33411138 DOI: 10.1007/s10067-020-05531-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the associations between restless sleep and knee symptoms among individuals with radiographically confirmed KOA. METHODS Cross-sectional and longitudinal associations were examined using Osteoarthritis Initiative (OAI) data. Participants with radiographic KOA (n = 2517) were asked how often sleep was restless in the past week over the 4 years, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used to measure knee symptoms. Adjusted β coefficients (aβ) and 95% confidence intervals (CI) were derived from generalized estimating equations (GEEs) models stratified by sex. RESULTS One in 7 participants reported ≥ 3 nights with restless sleep. Cross-sectional analyses indicated that restless sleep 5-7 nights was associated with worse symptoms (Women: pain: aβ 1.93, 95% CI 1.12-2.74, stiffness: aβ 0.57, 95% CI 0.19-0.94, physical function: aβ 5.68, 95% CI 3.09-8.27; Men: pain: aβ = 1.85, 95% CI 0.85-2.86; stiffness: aβ 0.63, 95% CI 0.15-1.12; physical function: aβ 5.89, 95% CI 2.68-9.09) compared with < 1 night. Longitudinal analyses confirmed that more nights with restless sleep were associated with worse pain (P trend = 0.01) and function (P trend = 0.04) in women and physical function in men (P trend = 0.04), although estimates did not meet thresholds for minimal clinically meaningful differences. CONCLUSION While the analysis of cross-sectional data supported the association between restless sleep and KOA symptoms, such relationships were not confirmed in more robust longitudinal analysis. Further research examining whether sleep quality, duration, or disorders is associated with worsening symptoms in persons with KOA is warranted. Key Points • The prevalence of frequent restless sleep among persons with knee OA is not uncommon. • There were linear trends between frequency of restless sleep and self-reported symptoms of the knee in cross-sectional analyses. • In the more robust longitudinal analysis, despite the statistically significant linear trends observed between frequency of restless sleep and symptoms (women: pain and physical function; men: function), none appeared to reach the a priori selected ranges for minimally clinically relevant differences.
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Affiliation(s)
- Kate L Lapane
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA
| | - Divya Shridharmurthy
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA
- Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Matthew S Harkey
- Department of Kinesiology, Michigan State University, East Lansing, MI, 48824, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, 02111, USA
| | - Catherine E Dubé
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA
| | - Shao-Hsien Liu
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA.
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21
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Park HM, Lee JH, Lee YJ. Positive Association of Serum Alkaline Phosphatase Level with Severe Knee Osteoarthritis: A Nationwide Population-Based Study. Diagnostics (Basel) 2020; 10:diagnostics10121016. [PMID: 33261160 PMCID: PMC7760969 DOI: 10.3390/diagnostics10121016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
Serum alkaline phosphatase (ALP), a well-known marker of hepatobiliary and bone disorders, has recently been discovered to be a biochemical marker of cardiometabolic diseases and chronic low-grade inflammation. We aimed to evaluate the association of serum ALP level with knee osteoarthritis in the general population. The study included 3060 men and women aged ≥50 years who participated in the 2009–2011 Korea National Health and Nutrition Examination Survey. The participants were categorized into three groups based on log-transformed serum ALP level as follows: T1 (1.74–2.32), T2 (2.33–2.43), and T3 (2.44–3.01). Their radiographs were evaluated by two well-trained radiologists using the Kellgren–Lawrence (KL) grading system. After excluding those with KL Grade 0, we categorized the remaining participants into two groups, a severe osteoarthritis group (KL Grade 4) and a non-severe osteoarthritis group (KL Grades 1 to 3). The odds ratios (ORs) with 95% confidence intervals (CIs) of severe osteoarthritis according to the tertiles of log-transformed serum ALP levels of patients with osteoarthritis were calculated using a weighted multivariate logistic regression analysis. Compared with T1, the adjusted ORs (95% CIs) for severe osteoarthritis of the T3 serum ALP group was 1.613 (1.087–2.394; p = 0.018) after adjusting for the confounding variables. Conclusively, serum ALP activity was independently and positively associated with severe knee osteoarthritis in middle-aged and older adults.
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Affiliation(s)
- Hye-Min Park
- Department of Family Medicine, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea;
- Department of Medicine, Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea;
| | - Jun-Hyuk Lee
- Department of Medicine, Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea;
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do 16995, Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea;
- Correspondence: ; Tel.: +82-2-2019-3481
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22
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Pan F, Tian J, Cicuttini F, Jones G. Sleep Disturbance and Its Association with Pain Severity and Multisite Pain: A Prospective 10.7-Year Study. Pain Ther 2020; 9:751-763. [PMID: 33085011 PMCID: PMC7648801 DOI: 10.1007/s40122-020-00208-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Sleep disturbance is often comorbid with chronic pain disorders, with emerging evidence suggesting a stronger effect of sleep disturbance on pain than vice versa; however, few studies have evaluated the long-term associations between sleep disturbance and pain. This study was to examine the associations of sleep disturbance with knee pain severity, number of painful sites (NPS) and persistent pain in a 10.7-year cohort study. METHODS A total of 1099 community-dwelling older adults (age mean ± SD, 63 ± 7.5 years; 51% female) were recruited and followed up at 2.6, 5.1 and 10.7 years later. Data on demographics, body mass index, physical activity and comorbidities were collected. At each time point, sleep disturbance, knee pain severity and NPS were assessed by using questionnaires. Multisite pain (MSP) was defined as NPS ≥ 2. Persistent knee pain or MSP was defined as having knee pain or MSP at all time points, respectively. Multivariable mixed-effects models and log-binomial regression were applied. RESULTS In multivariable analyses, sleep disturbance was associated with greater knee pain severity (β 0.91/unit, 95% CI 0.70-1.11) and more NPS [(relative risk (RR) 1.10/unit, 95% CI 1.07-1.14] in a dose-response manner. Persistent sleep disturbance was associated with persistent knee pain (RR 1.90, 1.26-2.87) and MSP (RR 1.29, 1.07-1.56). Persistent knee pain and MSP were also associated with persistent sleep disturbance (knee pain: RR = 1.99; MSP: RR = 2.71, both P < 0.05). CONCLUSIONS Sleep disturbance was independently associated with greater pain severity and NPS in a dose-response manner. A reciprocal relationship between persistent sleep disturbance and persistent pain suggests treating either problem could help the other.
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Affiliation(s)
- Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
| | - Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University Medical School, Commercial Road, Melbourne, VIC, 3181, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
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Núñez P, Perillan C, Arguelles J, Diaz E. Comparison of sleep and chronotype between senior and undergraduate university students. Chronobiol Int 2019; 36:1626-1637. [DOI: 10.1080/07420528.2019.1660359] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- P Núñez
- Departamento de Biología Funcional, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
| | - C Perillan
- Departamento de Biología Funcional, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
| | - J Arguelles
- Departamento de Biología Funcional, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
| | - E Diaz
- Departamento de Biología Funcional, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
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