Chronic Pain and Sleep Disturbances: A Pragmatic Review of Their Relationships, Comorbidities, and Treatments

Chronic Pain and Sleep Disturbances: A Pragmatic Review of Their Relationships, Comorbidities, and Treatments

Abstract Objective The objective of this review is to answer three questions: 1) How are chronic pain severity and pain duration affected in patients with chronic pain and sleep disturbances that occur simultaneously? 2) What are common comorbidities and pain-related symptoms seen in patients with c...

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Bibliographic Details
Published in:Pain medicine (Malden, Mass.) Vol. 21; no. 6; pp. 1142 - 1152
Main Authors: Husak, Aubrey J, Bair, Matthew J
Format: Journal Article
Language:English
Published: England Oxford University Press 01-06-2020
Subjects:
Care and treatment
Chronic pain
Chronic Pain - epidemiology
Chronic Pain - therapy
Clinical trials
Cognitive ability
Comorbidity
Complications and side effects
Depression
Fibromyalgia
Fibromyalgia - complications
Fibromyalgia - epidemiology
Fibromyalgia - therapy
Humans
Pain
Pain management
Patients
Psychotherapy
Risk factors
Sleep
Sleep and wakefulness
Sleep disorders
Sleep Wake Disorders - epidemiology
Sleep Wake Disorders - therapy
Suicidal behavior
United States
Sleep Disturbances
Pain Outcomes
Treatment
Insomnia
Comorbidity
Chronic Pain
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Summary:Abstract Objective The objective of this review is to answer three questions: 1) How are chronic pain severity and pain duration affected in patients with chronic pain and sleep disturbances that occur simultaneously? 2) What are common comorbidities and pain-related symptoms seen in patients with chronic pain and sleep disturbances? and 3) What are potentially effective pharmacological and nonpharmacological treatment options for both conditions? Methods Ovid Medline and PubMed were searched. Search terms included sleep wake disorder, chronic pain, fibromyalgia, treatment outcome, psychotherapy, complementary therapies, and therapeutics. Studies that assessed outcomes between individuals with chronic pain and those with concurrent chronic pain and sleep disturbances were included. Randomized controlled clinical trials of treatments for both conditions were included. Results Sixteen studies indicated that patients with both chronic pain and sleep disturbances have greater pain severity, longer duration of pain, greater disability, and are less physically active than those without sleep disturbances. Patients with both conditions are more likely to have concurrent depression, catastrophizing, anxiety, and suicidal ideation. Thirty-three randomized controlled trials assessed treatment for both chronic pain and sleep disturbances. Pregabalin was the most frequently studied medication, showing improvement in pain and sleep symptoms. Cognitive behavioral therapy for insomnia showed long-term improvement in sleep for patients with chronic pain. Conclusions Individuals with chronic pain and sleep disturbances have greater symptom severity, longer duration of symptoms, more disability, and additional comorbidities. Pharmacological and nonpharmacological treatments may be useful in the treatment of concurrent chronic pain and sleep disturbances, but further study is needed.
Bibliography:ObjectType-Article-2
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ObjectType-Review-1
ISSN:1526-2375
1526-4637
DOI:10.1093/pm/pnz343