Associations Among Sleep Disturbance, Pain Catastrophizing, and Pain Intensity for Methadone-maintained Patients With Opioid Use Disorder and Chronic Pain.
Associations Among Sleep Disturbance, Pain Catastrophizing, and Pain Intensity for Methadone-maintained Patients With Opioid Use Disorder and Chronic Pain.
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DOI：
10.1097/ajp.0000000000000848
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Barry DT
中科院分区：
文献类型：
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作者：
Ponce Martinez C;Edwards KA;Roos CR;Beitel M;Eller A;Barry DT
本研究探讨了接受美沙酮维持治疗（MMT）治疗阿片类药物使用障碍（OUD）并报告同时发生慢性疼痛的患者中疼痛强度、疼痛灾难化和睡眠障碍之间的横断面相关性。参与者为89例OUD和慢性疼痛患者，这些患者来自一项更大的横断面研究，该研究包括164名完成一系列自我报告措施的MMT患者。我们进行了六个调解模型，以测试所有可能的途径（即，每个变量作为自变量、中介变量或因变量进行测试）。唯一显著的中介作用是睡眠障碍通过疼痛灾难化对疼痛强度的间接影响。也就是说，更大的睡眠障碍与更大的疼痛灾难化有关，而疼痛灾难化又与更大的疼痛强度有关。总之，研究结果表明，睡眠障碍的疼痛灾难性的疼痛强度途径可能是一个关键的机制途径，加剧疼痛的MMT患者与OUD和慢性疼痛的问题。这些结果表明，针对睡眠障碍的干预措施可能是必要的MMT患者OUD和慢性疼痛。今后在这一领域的纵向数据的工作是必要的。
This study examined the cross-sectional associations among pain intensity, pain catastrophizing, and sleep disturbance among patients receiving methadone maintenance treatment (MMT) for opioid use disorder (OUD) and reporting co-occurring chronic pain. Participants were 89 patients with OUD and chronic pain drawn from a larger cross-sectional study of 164 MMT patients who completed a battery of self-report measures. We conducted six mediation models to test all possible pathways (i.e., each variable tested as an independent variable, mediator, or dependent variable). The only significant mediation effect was an indirect effect of sleep disturbance on pain intensity via pain catastrophizing. That is, greater sleep disturbance was associated with greater pain catastrophizing, which in turn was associated with greater pain intensity. Altogether, findings suggest that the sleep disturbance to pain catastrophizing to pain intensity pathway may be a key mechanistic pathway exacerbating pain issues among MMT patients with OUD and chronic pain. These results suggest that interventions targeting sleep disturbance may be warranted among MMT patients with OUD and chronic pain. Future work in this area with longitudinal data is warranted.