Pain Expectancy and Positive Affect Mediate the day-to-day Association Between Objectively Measured Sleep and Pain Severity Among Women With Temporomandibular Disorder.
Pain Expectancy and Positive Affect Mediate the day-to-day Association Between Objectively Measured Sleep and Pain Severity Among Women With Temporomandibular Disorder.
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DOI：
10.1016/j.jpain.2021.11.003
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Smith MT
中科院分区：
文献类型：
--
作者：
Mun CJ;Weaver KR;Hunt CA;Owens MA;Phillips J;Lerman SF;Buenaver LF;Colloca L;Tennen H;Haythornthwaite JA;Finan PH;Smith MT
大多数患有颞下颌关节紊乱病(TMD)的人都经历过睡眠障碍，这可能会维持和加剧慢性疼痛。然而，睡眠-疼痛联系的潜在因素还没有完全阐明，特别是在实验室之外。睡眠剥夺会导致威胁解读偏向，以及积极情感功能的损害。使用活动记录仪和日常日记，我们检验了早晨疼痛预期和积极情绪是否在前一天晚上的睡眠障碍和第二天的总体疼痛严重程度之间起到了中介作用。选择总睡眠时间(TST)作为衡量睡眠的主要指标。样本包括144名患有TMD的女性(平均年龄=36岁[SD=11.1])，她们至少表现出亚临床失眠。通过同步睡眠日记对14天的睡眠活动进行评估。对疼痛相关经历和情感状态的每日日记评估在相同的14天内每天进行两次(一次在参与者醒来时，另一次在入睡前)。多水平结构方程模型显示，早晨的疼痛预期(95%CI：−.0004，−.00003)和积极情绪(95%CI：−.0005，−.000001)都在前一天晚上的时间间隔时间和第二天的总体疼痛严重程度之间起中介作用，因此前一天晚上较短的时间间隔时间与较高的第二天早上疼痛预期和较低的积极情绪有关，这反过来又与第二天的总体疼痛严重程度相关，同时控制了早上的疼痛严重程度。减少夸大的日常疼痛预期和上调积极情绪可能是在TMD和睡眠障碍并存的个体中脱离睡眠-疼痛联系的重要干预目标。
The majority of individuals with temporomandibular disorders (TMD) experience sleep disturbance, which can maintain and exacerbate chronic pain. However, the factors underlying the sleep-pain link have not been fully elucidated, especially beyond the laboratory. Sleep deprivation can induce threat interpretation bias, as well as impairment in positive affective functioning. Using both actigraphy and daily diaries, we examined whether morning pain expectancy and positive affect mediate the association between previous night’s sleep disturbance and next-day overall pain severity. Total sleep time (TST) was selected as the primary measure of sleep. The sample included 144 women (mean age=36 [SD=11.1]) with TMD who displayed at least subclinical insomnia. Sleep was assessed for 14 days using actigraphy which was validated by concurrent sleep diaries. Daily diary assessments of pain-related experiences and affective states were conducted twice per day (i.e., once upon participants’ waking and the other prior to going to sleep) for the same 14-day period. Multilevel structural equation modeling revealed that both morning pain expectancy (95% CI: −.0004, −.00003) and positive affect (95% CI: −.0005, −.000001) mediated the association between previous night’s TST and next-day’s overall pain severity, such that shorter previous night TST was associated with higher next-morning pain expectancy and lower positive affect, which in turn were associated with a greater level of next-day’s overall pain severity while controlling for morning pain severity. Reducing exaggerated daily pain expectancy and up-regulating positive affect may be important intervention targets for disengaging the sleep-pain link among individuals with co-occurring TMD and sleep disturbance.
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影响因子：
10.5
作者：
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通讯作者：
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