Factors Associated with Increased Risk for Clinical Insomnia in Patients with Chronic Neck Pain

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Factors Associated with Increased Risk for Clinical Insomnia in Patients with Chronic Neck Pain
Key Take-Away: 

Chronic neck pain (CNP) is among the most commonly reported health complaints in people with chronic musculoskeletal pain and it has many negative effects on the quality of life. This research report has shown that high pain intensity, co-morbid musculoskeletal pain and a high level of depression are strongly associated with clinical insomnia in chronic neck pain.

Insomnia is highly prevalent among people with chronic pain conditions. 

ABSTRACT: 
Background: 

Insomnia is highly prevalent among people with chronic pain conditions.

Because insomnia has been shown to worsen pain, mood, and physical functioning, it could negatively impact the clinical outcomes of patients with chronic pain. To determine the risk factors associated with clinical insomnia in chronic neck pain (CNP) patients.

 

Methods: 

Outpatient department for interventional pain management at a university hospital.

Data from 218 CNP patients were analyzed in this study. The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score >/= 15). Patient demographics and pain-related factors were evaluated with logistic regression analysis to identify risk factors of clinical insomnia in CNP.

 

Results: 

In total, 53.7% of patients reported mild to severe insomnia after neck pain development; 22.9% of patients met the criteria for clinically significant insomnia (ISI score >/=15).

In multivariate analysis, high pain intensity, the presence of co-morbid musculoskeletal pain, and a high level of depression were strongly associated with clinical insomnia in patients with CNP. Among these factors, a greater level of depression was the strongest predictor of clinical insomnia, with the highest odds ratio of 3.689 (95% CI1.570 – 8.667). This study was conducted in a single clinical setting including a selected study population with a homogeneous racial background. The ISI does not include several sleep-related variables, the roles of which are unknown in determining insomnia severity.

 

Conclusion: 

Insomnia should be addressed as an indispensable part of pain management in CNP patients with these risk factors, especially depression.

 

Pain Physician 2015 Nov;18(6):593-8

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