Abstract
This study was designed (1) to characterize the extent and nature of sleep complaints of chronic pain patients and (2) to examine the factors that predict sleep quality. A heterogeneous sample of 51 outpatients with benign, chronic pain was recruited from newspaper and pain clinic advertisements. Patients completed a variety of self-report instruments including the Multidimensional Pain Inventory, the Pittsburgh Sleep Quality Index, the Pre-Sleep Arousal Scale, and the Beck Depression Inventory. Sleep complaints were reported by 88% of the sample. Presleep cognitive arousal, rather than pain severity, was found to be the primary predictor of sleep quality.
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REFERENCES
Atkinson, J. H., Ancoli-Israel, S., Slater, M. A., Garfin, S. R., and Gillin, J. C. (1988). Subjective sleep disturbance in chronic back pain. Clin. J. Pain 4: 225-232.
Beck, A. T., and Steer, R. A. (1984). Internal consistencies of the original and revised Beck Depression Inventory. J. Clin. Psychol. 40: 1365-1367.
Beck, A. T., Ward, C., Mendelson, M., Mock, J., and Erbaugh, J. (1961). An inventory for measuring depression. Arch. Gen. Psychiatry 4: 561-571.
Bonnet, M. H., and Arand, D. L. (1992). Caffeine use as a model of acute and chronic insomnia. Sleep 15: 526-536.
Bonnet, M. H., and Arand, D. L. (1995). 24-hour metabolic rate in insomniacs and matched normal sleepers. Sleep 18(7): 581-588.
Bonnet, M. H., and Arand, D. L. (1997). Hyperarousal and insomnia. Sleep Med. Res. 1: 97-108.
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., and Kupfer, D. J. (1988). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res. 28: 193-213.
Buysse, D. J., Reynolds, C. F., Monk, T. H., Hoch, C. C., Yeager, A. L., and Kupfer, D. J. (1991). Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep 14: 331-338.
Cooperman, N. R., Mullin, F. J., and Kleitman, N. (1934). Studies on the physiology of sleep XI: Further observations on the effects of prolonged sleeplessness. Am. J. Physiol. 107: 589-594.
Fisher, K., and Johnston, M. (1998). Emotional distress and control cognitions as mediators of the impact of chronic pain on disability. Bri. J. Health Psychol. 3: 225-236.
Gross, R., and Borkovec, T. (1982). Effects of cognitive intrusion manipulation on the sleep onset latency of good sleepers. Behav. Ther. 13: 112-116.
Hall, M., Buysse, D. J., Reynolds, C. F., Kupfer, D. J., and Baum, A. (1996). Stress related intrusive thoughts disrupt sleep onset and continuity. Sleep Res. 25: 163.
Harness, D. M., and Peltier, B. (1992). Comparison of MMPI scores with self-report of sleep disturbance and bruxism in the facial pain population. Cranio 10(1): 70-74.
Haythornthwaite, J. A., Hegel, M. T., and Kerns, R. D. (1991). Development of a sleep diary for chronic pain patients. J. Pain Symptom Manage. 65(2): 65-71.
Johnson, L. (1969). Psychological and physiological changes following total sleep deprivation. In Kales, A. (ed.), Sleep Physiology and Pathology, Lippincott, Philadelphia.
Kerns, R. D., Turk, D. C., and Rudy, T. E. (1985). West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain 23: 345-356.
Kuisk, L. A., Bertelson, A. D., and Walsh, J. K. (1989). Pre-sleep cognitive hyperarousal and affect as factors in objective and subjective Insomnia. Percept. Motor Skills 69: 1219-1225.
Lamberg, L. (1999). Chronic pain linked with poor sleep: Exploration of causes and treatment [news]. JAMA 281(8): 691-692.
Latham, J., and Davis, B. D. (1994). The Socioeconomic impact of chronic pain. Disabil. Rehab. 16(1): 39-44.
Lichstein, K., and Rosenthal, T. (1980). Insomniacs' perceptions of cognitive versus somatic determinants of sleep disturbance. J. Abnorm. Psychol. 89(1): 105-107.
Moldofsky, H., and Scarisbrick, P. (1976). Induction of neurasthenic musculoskeletal pain syndrome by selective sleep deprivation. Psychosom. Med. 38: 35-44.
Moldofsky, H., Scarisbrick, P., England, R., and Smythe, H. (1975). Musculoskeletal symptoms and non-REM sleep disturbance in patients with “fibrositis syndrome” and healthy subjects. Psychosom. Med. 37(4): 341-351.
Monroe, L. J. (1967) Psychological and physiological differences between good and poor sleepers. J. Abnorm. Psychol. 72: 255-264.
Morin, C. M., Gibson, D., and Wade, J. (1998). Self-reported sleep and mood disturbance in chronic pain patients. Clin. J. Pain. 14(4): 311-314.
Morin, C. M., Kowatch, R. A., and Wade, J. (1989). Behavioral management of sleep disturbances secondary to chronic pain. J. Behav. Ther. Exp. Psychiatry 10(4): 295-302.
Nicassio, P. M., and Wallston, K. A. (1992). Longitudinal relationships among pain, sleep problems, and depression in rheumatoid arthritis. J. Abnorm. Psychol. 101(3): 514-520.
Nicassio, P., Mendlowitz, D., Fussell, J., and Petras, L. (1985). The phenomenology of the pre-sleep state: The development of the Pre-Sleep Arousal Scale. Behav. Res. Ther. 23(3): 263-271.
Nielsen, K. D., Drewes, A. M., Svendsen, L., Bjerregard, K., and Taagholt, S. (1994). Ambulatory recording and power spectral analysis by autoregressive modeling of polygraphic sleep signals in patients suffering from chronic pain. Methods Inform. Med. 33(1): 76-78.
Perlis, M. L., Giles, D. E., Mendelson, W. B., Bootzin, R. R., and Wyatt, J. K. (1997). Subjective-objective discrepancies in psychophysiological insomnia: The behavioral model and a neurocognitive perspective. J. Sleep Res. 6: 179-188.
Pilowsky, I., Crettenden, I., and Townley, M. (1985). Sleep disturbance in pain clinic patients. Pain 23: 27-33.
Smith, R. G. (1992). The epidemiology and treatment of depression when it coexists with somatoform disorders, somatization or depression. Gen. Hosp. Psychiatry. 14: 265-272.
Spielman, A., Caruso, L., and Glovinsky, P. A. (1987a). A behavioral perspective on insomnia treatment. Psychiatr. Clin. North Am. 10: 541-553.
Spielman, A. J., Saskin, P., and Thorpy, M. J. (1987b). Treatment of chronic insomnia by restriction of time in bed. Sleep 10: 45-56.
Wells, N. (1994). Perceived control over pain: Relation to distress and disability. Res. Nurs. Health 17: 295-302.
Wilson, K. G., Watson, S. T., and Currie, S. R. (1998). Daily and ambulatory activity monitoring of sleep in patients with insomnia associated with chronic musculoskeletal pain. Pain 75: 75-84.
Wittig, R. M., Zorick, F. J., Blumer, D., Heilbronn, M., and Roth, T. (1982). Disturbed Sleep in patients complaining of chronic pain. J. Nerv. Ment. Dis. 170(7): 429-431.
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Smith, M.T., Perlis, M.L., Smith, M.S. et al. Sleep Quality and Presleep Arousal in Chronic Pain. J Behav Med 23, 1–13 (2000). https://doi.org/10.1023/A:1005444719169
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DOI: https://doi.org/10.1023/A:1005444719169