Long-term improvements in sleep, pain, depression, and fatigue in older adults with comorbid osteoarthritis pain and insomnia.
Long-term improvements in sleep, pain, depression, and fatigue in older adults with comorbid osteoarthritis pain and insomnia.
复制标题
长期改善患有骨关节炎疼痛和失眠的老年人的睡眠、疼痛、抑郁和疲劳。
DOI：
10.1093/sleep/zsab231
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发表时间：
2022
期刊：
影响因子：
5.6
通讯作者：
McCurry,SusanM
中科院分区：
文献类型：
--
作者：
Vitiello,MichaelV;Zhu,Weiwei;VonKorff,Michael;Wellman,Robert;Morin,CharlesM;Yeung,Kai;McCurry,SusanM
在327名患有慢性骨关节炎（OA）疼痛和失眠的老年人（年龄60岁以上）的初级保健人群中，我们通过随机对照试验数据的二次分析，研究了睡眠或疼痛的短期改善与长期睡眠，疼痛，抑郁和疲劳之间的关系。研究受试者（不考虑试验组）被分类为睡眠或疼痛改善者，基线至2个月时，失眠严重程度指数或简明疼痛量表分别降低≥30%，或睡眠或疼痛非改善者。在控制了试验组和潜在混杂因素后，与相应的非改善者相比，睡眠和疼痛改善者在12个月内在强迫症严重程度指数（ISI）、匹兹堡睡眠质量指数、简明疼痛量表-简表（总量表、干扰量表和严重程度量表）、患者健康问卷和弗林德斯疲劳量表方面均显示出显著（p< .01）的持续改善。对于所有变量，睡眠和疼痛改善剂与其各自的非改善剂相比的持续益处的效应量（Cohen'sf 2）都很小（<0.15），除了睡眠改善剂的失眠症状持续减少的中等效应量。我们的结论是，合并失眠的疼痛人群的短期睡眠改善不仅有利于长期睡眠改善，而且有利于长期减轻疼痛，沿着抑郁和疲劳的改善。疼痛的短期改善似乎有类似的长期后遗症。成功地改善患有失眠症的疼痛人群的睡眠可能具有改善短期和长期疼痛、抑郁和疲劳的额外益处。试验注册：骨关节炎和睡眠治疗（OATS）NCT 02946957：https://clinicaltrials.gov/ct2/show/NCT02946957。
In a primary care population of 327 older adults (age 60+) with chronic osteoarthritis (OA) pain and insomnia, we examined the relationship between short-term improvement in sleep or pain and long-term sleep, pain, depression, and fatigue by secondary analyses of randomized controlled trial data. Study participants, regardless of trial arm, were classified as Sleep or Pain Improvers with ≥30% baseline to 2-month reduction on the Insomnia Severity Index or the Brief Pain Inventory, respectively, or Sleep or Pain Non-Improvers. After controlling for trial arm and potential confounders, both Sleep and Pain Improvers showed significant (p< .01) sustained improvements across 12 months compared to respective Non-Improvers for the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index, Brief Pain Inventory-short form (total, Interference, and Severity subscales), Patient Health Questionnaire, and Flinders Fatigue Scale. The effect sizes (Cohen’sf2) for the sustained benefits in both Sleep and Pain Improvers compared to their respective Non-Improvers for all variables were small (<0.15) with the exception of medium effect size for sustained reduction in insomnia symptoms for the Sleep Improvers. We conclude that short-term sleep improvements in pain populations with comorbid insomnia precede benefits not only for long-term improvement in sleep but also for reduced pain over the long-term, along with associated improvements in depression and fatigue. Short-term improvements in pain appear to have similar long-term sequelae. Successfully improving sleep in pain populations with comorbid insomnia may have the additional benefits of improving both short- and long-term pain, depression, and fatigue.Trial Registration: OsteoArthritis and Therapy for Sleep (OATS) NCT02946957: https://clinicaltrials.gov/ct2/show/NCT02946957.