Independent and Combined Associations of Depressive Symptoms and Sleep Disturbance with Chronic Pain in Community-dwelling Older Adults

Overview

Journal Pain Rep

Publisher Wolters Kluwer

Date 2022 Sep 21

PMID 36128044

Authors

Takafumi Saito

Tao Chen

Harukaze Yatsugi

Tianshu Chu

Xin Liu

Hiro Kishimoto

Affiliations

Soon will be listed here.

Abstract

Introduction: There is limited evidence regarding whether depressive symptoms and sleep disturbance are independently or synergistically associated with chronic pain.

Objectives: We investigated the independent and combined associations of depressive symptoms and sleep disturbance with chronic pain and its severity (and the additive interactions) in community-dwelling older adults.

Methods: This cross-sectional study analyzed the data of 1374 individuals who were 65 to 75 year old, not in need of long-term care, and completed questionnaires assessing sociodemographic factors, depressive symptoms, sleep disturbance, and chronic pain. The severity of chronic pain was assessed based on pain intensity, pain distribution, and pain type. The participants' status of depressive symptoms and sleep disturbance were categorized in the following 4 groups: neither condition, depressive symptoms alone, sleep disturbance alone, and both conditions.

Results: Among the 1374 participants, 849 (61.8%) had chronic pain. The multivariable-adjusted odds ratios and 95% confidence intervals of the presence of chronic pain in those with depressive symptoms alone, sleep disturbance alone, and both conditions were 1.40 (0.97-2.03), 1.98 (1.41-2.78), and 2.12 (1.39-2.23), respectively, compared with the neither-condition group. Similar associations were observed for severe chronic pain. However, there were no significant additive interactions. In addition, only sleep disturbance was significantly associated with chronic pain, after adjusting for depressive symptoms.

Conclusions: Our analyses did not reveal a synergistic effect of depressive symptoms and sleep disturbance on chronic pain and its severity, suggesting that most of the effects of depressive symptoms on chronic pain may be mediated by sleep disturbance.

References

Generaal E, Vogelzangs N, Penninx B, Dekker J . Insomnia, Sleep Duration, Depressive Symptoms, and the Onset of Chronic Multisite Musculoskeletal Pain. Sleep. 2017; 40(1). DOI: 10.1093/sleep/zsw030. View

Zhang P, Lou P, Chang G, Chen P, Zhang L, Li T . Combined effects of sleep quality and depression on quality of life in patients with type 2 diabetes. BMC Fam Pract. 2016; 17:40. PMC: 4820902. DOI: 10.1186/s12875-016-0435-x. View

Matsubayashi Y, Takeshita K, Sumitani M, Oshima Y, Tonosu J, Kato S . Validity and reliability of the Japanese version of the painDETECT questionnaire: a multicenter observational study. PLoS One. 2013; 8(9):e68013. PMC: 3787034. DOI: 10.1371/journal.pone.0068013. View

Stubbs B, Vancampfort D, Veronese N, Thompson T, Fornaro M, Schofield P . Depression and pain: primary data and meta-analysis among 237 952 people across 47 low- and middle-income countries. Psychol Med. 2017; 47(16):2906-2917. DOI: 10.1017/S0033291717001477. View

Afari N, Ahumada S, Wright L, Mostoufi S, Golnari G, Reis V . Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis. Psychosom Med. 2013; 76(1):2-11. PMC: 3894419. DOI: 10.1097/PSY.0000000000000010. View

Ohayon M, Stingl J . Prevalence and comorbidity of chronic pain in the German general population. J Psychiatr Res. 2012; 46(4):444-50. DOI: 10.1016/j.jpsychires.2012.01.001. View

Andersson T, Alfredsson L, Kallberg H, Zdravkovic S, Ahlbom A . Calculating measures of biological interaction. Eur J Epidemiol. 2005; 20(7):575-9. DOI: 10.1007/s10654-005-7835-x. View

Freynhagen R, Baron R, Gockel U, Tolle T . painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006; 22(10):1911-20. DOI: 10.1185/030079906X132488. View

Whibley D, AlKandari N, Kristensen K, Barnish M, Rzewuska M, Druce K . Sleep and Pain: A Systematic Review of Studies of Mediation. Clin J Pain. 2019; 35(6):544-558. PMC: 6504189. DOI: 10.1097/AJP.0000000000000697. View

10.

Larsson B, Bjork J, Borsbo B, Gerdle B . A systematic review of risk factors associated with transitioning from regional musculoskeletal pain to chronic widespread pain. Eur J Pain. 2012; 16(8):1084-93. DOI: 10.1002/j.1532-2149.2012.00117.x. View

11.

Cohen S, Vase L, Hooten W . Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021; 397(10289):2082-2097. DOI: 10.1016/S0140-6736(21)00393-7. View

12.

Staples L, Dear B, Gandy M, Fogliati V, Fogliati R, Karin E . Psychometric properties and clinical utility of brief measures of depression, anxiety, and general distress: The PHQ-2, GAD-2, and K-6. Gen Hosp Psychiatry. 2018; 56:13-18. DOI: 10.1016/j.genhosppsych.2018.11.003. View

13.

Kessler R, Andrews G, Colpe L, Hiripi E, Mroczek D, Normand S . Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002; 32(6):959-76. DOI: 10.1017/s0033291702006074. View

14.

Buenaver L, Quartana P, Grace E, Sarlani E, Simango M, Edwards R . Evidence for indirect effects of pain catastrophizing on clinical pain among myofascial temporomandibular disorder participants: the mediating role of sleep disturbance. Pain. 2012; 153(6):1159-1166. DOI: 10.1016/j.pain.2012.01.023. View

15.

Boakye P, Olechowski C, Rashiq S, Verrier M, Kerr B, Witmans M . A Critical Review of Neurobiological Factors Involved in the Interactions Between Chronic Pain, Depression, and Sleep Disruption. Clin J Pain. 2015; 32(4):327-36. DOI: 10.1097/AJP.0000000000000260. View

16.

Rayner L, Hotopf M, Petkova H, Matcham F, Simpson A, McCracken L . Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs. Pain. 2016; 157(7):1472-9. PMC: 4912238. DOI: 10.1097/j.pain.0000000000000542. View

17.

Wilson K, Eriksson M, DEon J, Mikail S, Emery P . Major depression and insomnia in chronic pain. Clin J Pain. 2002; 18(2):77-83. DOI: 10.1097/00002508-200203000-00002. View

18.

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

19.

St Sauver J, Warner D, Yawn B, Jacobson D, McGree M, Pankratz J . Why patients visit their doctors: assessing the most prevalent conditions in a defined American population. Mayo Clin Proc. 2013; 88(1):56-67. PMC: 3564521. DOI: 10.1016/j.mayocp.2012.08.020. View

20.

Ferro M . The Psychometric Properties of the Kessler Psychological Distress Scale (K6) in an Epidemiological Sample of Canadian Youth. Can J Psychiatry. 2019; 64(9):647-657. PMC: 6699029. DOI: 10.1177/0706743718818414. View