Sleep quality and the role of sleep medications for veterans with chronic pain
Sleep quality and the role of sleep medications for veterans with chronic pain
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DOI：
10.1111/j.1526-4637.2006.00110.x
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发表时间：
2006-03-01
期刊：
影响因子：
3.1
通讯作者：
Clark, JD
中科院分区：
文献类型：
--
作者：
Chapman, JB;Lehman, CL;Clark, JD
客观的。本研究的目的是调查到疼痛诊所就诊的退伍军人的睡眠问题的性质、预测服用安眠药可能性的因素、处方药物的类型以及安眠药使用与睡眠质量、疼痛和抑郁之间的关系。设计/设置/患者。参与者是转诊至退伍军人事务部疼痛门诊的连续 201 名患者。他们在入院时和 2 个月随访时接受了匹兹堡睡眠质量指数、多维疼痛量表和贝克抑郁量表。还监测了睡眠和阿片类药物处方。结果。疼痛严重程度并不能预测总体睡眠质量；整体睡眠质量并不能预测疼痛的严重程度。抑郁程度越高，疼痛就越严重，睡眠障碍也就越严重。之前服用过此类药物是在 2 个月评估时服用安眠药物的唯一显着预测因素。对于 45% 服用睡眠药物的参与者来说，这些药物与疼痛因素或抑郁症的任何显着变化无关。然而，睡眠药物的使用与整体睡眠质量、睡眠持续时间和睡眠效率较差相关。阿片类药物处方并不是睡眠因素、疼痛相关变量或抑郁症状的显着预测因子。讨论。结果表明，在该人群中，抑郁症可能比疼痛相关变量对睡眠问题的影响更大。这些数据表明需要对睡眠药物进行对照、前瞻性研究，以进一步研究睡眠药物对慢性疼痛患者睡眠成分的影响。
Objective. The purpose of this study was to investigate the nature of sleep problems in veterans presenting to a pain clinic, factors that predict likelihood of being prescribed a sleep medication, types of medications prescribed, and the relationships between sleep medication use and sleep quality, pain, and depression.Design/Setting/Patients. Participants were 201 consecutive patients referred to a Veterans Affairs outpatient pain clinic. They were administered the Pittsburgh Sleep Quality Index, Multidimensional Pain Inventory, and Beck Depression Inventory at intake and 2-month follow-up. Sleep and opioid medication prescriptions were also monitored.Results. Pain severity did not predict global sleep quality; global sleep quality was not predictive of pain severity. Greater depression predicted both more severe pain and more sleep impairment. Having previously been prescribed such medications was the only significant predictor of being prescribed a sleep medication at the time of the 2-month assessment. For the 45% of participants on sleep medications, these medications were not associated with any significant change in pain factors or depression. However, sleep medication use was associated with worse global sleep quality, sleep duration, and sleep efficiency. Opioid prescription was not a significant predictor of sleep factors, pain-related variables, or depression symptoms.Discussion. Results suggest depression may contribute more significantly to sleep problems than pain-related variables in this population. The data suggest the need for controlled, prospective studies of sleep medication to further investigate the impact of sleep medications on sleep components in patients with chronic pain.