The Role of Sleep Quality and Fatigue on the Benefits of an Interdisciplinary Treatment for Adults With Chronic Pain

Abstract

Background Interdisciplinary chronic pain treatment is effective for reducing pain intensity and pain‐related disability, and for improving psychological function. However, the mechanisms that underlie these treatment‐related benefits are not yet well understood. Sleep problems and fatigue are modifiable factors often comorbid with chronic pain. The goal of this study was to evaluate the role that changes in sleep quality and fatigue might have on the benefits of an interdisciplinary chronic pain treatment. Methods A total of 125 adults with chronic pain participated in a 4‐week interdisciplinary pain management program. Measures of depression, sleep disturbance, fatigue, pain intensity, and physical function were administered at pre‐ and post‐treatment. Three regression analyses were conducted to evaluate the contribution of pre‐ to post‐treatment improvements in fatigue and sleep disturbance to the pre‐ to post‐treatment improvements in pain intensity, disability, and depression, while controlling for demographic characteristics (age and sex) and pain intensity. Results Changes in fatigue and sleep disturbance made independent and significant contributions to the prediction of treatment‐related benefits in pain intensity; improvements in depressive symptoms were predicted by improvements in fatigue, and improvements in disability were only predicted by pre‐treatment and pre‐ to post‐treatment decreases in pain intensity (one of the control variables). Conclusions In addition to sleep, fatigue emerged as a key potential mechanism of multidisciplinary chronic pain treatment‐related improvements, suggesting that interventions including elements that effectively target sleep and fatigue may enhance the efficacy of interdisciplinary chronic pain programs. This possibility should be evaluated in future research.

Associations between pain, self-efficacy, sleep duration, and symptoms of depression in adolescents: a cross-sectional survey

“…These results are consistent with those of a study of Swedish adolescents, which reported an association between short sleep duration and increased odds of pain problems [38]. Other studies have also demonstrated a link between poor sleep quality and increased pain during adolescence [39,40]. Disturbed sleep may affect the lives of adolescents in various ways and may manifest as issues associated with schoolrelated problems, poor concentration, and social problems [16].…”

Multisystem Resiliency as a Predictor of Physical and Psychological Functioning in Older Adults With Chronic Low Back Pain

“…Although sleep and pain are temporally related, sleep quality appears to have a more robust influence on pain symptomatology than vice versa (Finan et al, 2013; Gerhart et al, 2017), and may even serve as a risk factor for pain development and chronification (Gupta et al, 2007; Finan et al, 2013). Likewise, intervening on sleep may have salutary effects on pain, with recent evidence highlighting the influence that treatment-related sleep improvements have on pain intensity (de la Vega et al, 2019). Exercise as a therapeutic modality also confers many health benefits but can be especially potent for pain symptomatology.…”

Sleep disorders in patients with primary ciliary dyskinesia, cystic fibrosis with and without pancreatic insufficiency

“…The current study was not designed to address the mechanism for the above mentioned correlation, although this may be explained by current literature. Pain is a well described modulator of sleep quality in chronic illness, with bi-directional relationship through which poor sleep increases pain perception and severe pain impairs sleep [37,38]. Specifically in CF, both children and adults, report higher prevalence of chronic pain and perceive the disease as being painful [39].…”