Understanding the different relationships between mood and sleep disorders in several groups of non-oncological patients with chronic pain

Abstract

Objective: To compare sleep dimensions in patients suffering from chronic pain of different origins, and with a group of pain-free subjects. To analyze the relationship between depression and/or anxiety and sleep disorders in musculoskeletal, neuropathic, and fibromyalgia patients.

Methods: This cross-sectional study included patients diagnosed with neuropathic pain (NP) (n = 104), musculoskeletal pain (MSK) (n = 99), or fibromyalgia (FM) (n = 51), and pain free subjects (n = 72). Information about sleep dimensions (MOS-sleep), duration and intensity of pain (Visual Analog Scale), and anxiety and depression (Hospital Anxiety and Depression scale) was collected.

Results: Of the 254 patients with chronic pain (PCP) studied, the mean pain intensity was 6.6 (SD = 1.9), with an average duration of 9 years. The scores in all sleep dimensions of the MOS-sleep were higher in CPP (more disturbances) compared to pain free patients, and differences were observed among the three groups of PCP, with FM most severely affected. Anxiety (β = 1.3), depression (β = 1.1), intensity (β = 1.7), and duration of pain (β = 0.04) were associated with more sleep problems in MSK patients. In contrast, anxiety (β = 2.5) and duration of pain (β = 0.05) were negatively related to sleep in the NP patients, and only depression (β = 1.3) affected FM patients.

Conclusions: The sleep pattern differs among groups of PCP in the presence or absence of mood disorders. Understanding these disorders in each specific group of PCP is fundamental, and it can contribute to improve the clinical situation of the patients and better orientating therapeutic strategies.

Keywords:

• Chronic pain
• sleep disorders
• anxiety
• depression
• mood disorders

Transparency

Declaration of funding

This work was supported by the External Chair of Pain, a collaboration between the University of Cádiz and the Grünenthal Foundation. The Grünenthal Foundation is a private non-profit making organization that promotes the dissemination of scientific knowledge and supports research.

Declaration of financial/other relationships

The authors have no conflicts of interest to declare. No member of Grünenthal Foundation staff had any role in the interpretation of data, in the writing of the report or in the decision to submit the paper for publication to the journal. CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

No assistance in the preparation of this article is to be declared.