Insomnia Symptoms and Chronic Pain among Patients Participating in a Pain Rehabilitation Program—A Registry Study
Abstract
:1. Background
2. Materials and Methods
3. Results
3.1. Baseline
3.2. Associations of Insomnia at Baseline and Outcomes at the Follow-Up
4. Discussion
5. Clinical Implications and Future Research
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Women | Men | Total | ||||
---|---|---|---|---|---|---|---|
n | % | n | % | n | % | ||
Education | University | 2333 | 40 | 400 | 26 | 704 | 37 |
High school | 2396 | 41 | 807 | 52 | 3203 | 44 | |
Elementary school | 477 | 8 | 227 | 15 | 2733 | 10 | |
Other | 604 | 10 | 106 | 7 | 710 | 10 | |
country of birth | Sweden | 5315 | 81 | 1420 | 80 | 6735 | 81 |
Other Nordic | 158 | 2 | 38 | 2 | 196 | 2 | |
Other European | 318 | 5 | 81 | 5 | 399 | 5 | |
Other | 800 | 12 | 237 | 13 | 1037 | 12 | |
Pain frequency | Persistent | 4939 | 79 | 1351 | 80 | 6290 | 79 |
Periodic | 1337 | 21 | 344 | 20 | 1681 | 21 | |
Median | (q1, q3) | Median | (q1, q3) | Median | (q1, q3) | ||
Pain intensity, NRS (0–10) | 7 | (6, 8) | 7 | (5, 8) | 7 | (6, 8) | |
Pain duration (months) | 63 | (26, 165) | 58 | (22, 141) | 62 | (25, 161) | |
Number of pain sites (0–36) | 15 | (9, 22) | 10 | (6, 16) | 14 | (8, 21) | |
Women | Men | Total | |||||||
---|---|---|---|---|---|---|---|---|---|
ISI | n | % | 95% CI | n | % | 95% CI | n | % | 95% CI |
Severe insomnia (ISI 22–28) | 1589 | 26 | 24.87; 27.07 | 440 | 26 | 24.14; 28.25 | 2029 | 26 | 25.04; 26.99 |
Moderate insomnia (ISI 15–21) | 2488 | 41 | 39.42; 41.88 | 648 | 39 | 36.27; 40.92 | 3136 | 40 | 39.11; 41.29 |
Sub-threshold insomnia (ISI 8–14) | 1427 | 23 | 22.27; 24.39 | 401 | 24 | 21.89; 25.97 | 1828 | 23 | 22.50; 24.38 |
No insomnia (ISI 0–7) | 618 | 10 | 9.36; 10.87 | 191 | 11 | 9.94; 12.98 | 809 | 10 | 9.71; 11.07 |
Clinical insomnia (ISI > 14) | 4077 | 67 | 65.40; 67.77 | 1088 | 65 | 62.45; 67.01 | 5165 | 66 | 65.14; 67.24 |
Variables | n | OR | 95% CI | p | |
---|---|---|---|---|---|
Age (one year increasing aging) | 6454 | 1.01 | 1.00–1.01 | 0.024 | |
Gender (ref: male) | 5095 | 1.05 | 0.92–1.21 | 0.443 | |
Country of birth (ref: Sweden, n = 5854) | Nordic countries | 88 | 1.06 | 0.67–1.70 | <0.001 |
Europe | 123 | 2.07 | 1.33–3.33 | ||
Other | 389 | 1.91 | 1.48–2.51 | ||
Level of education (ref: elementary school, n = 623) | High school | 2870 | 0.88 | 0.72–1.07 | 0.028 |
University | 2330 | 0.81 | 0.66–0.99 | ||
Other | 631 | 1.05 | 0.82–1.35 | ||
Pain frequency (ref: periodically recurring, n = 1362) | Persistent | 5092 | 1.17 | 1.02–1.34 | 0.026 |
Pain intensity (NRS 0–10) | 6454 | 1.25 | 1.21–1.30 | <0.001 | |
Number of pain sites (0–36 places) | 6454 | 1.03 | 1.02–1.03 | <0.001 |
Women | Men | Total | |||||||
---|---|---|---|---|---|---|---|---|---|
n | % | 95% CI | n | % | 95% CI | n | % | 95% CI | |
Severe insomnia (ISI 22–28) | 759 | 14 | 13.2–15.1 | 245 | 17 | 15.4–19.3 | 1004 | 15 | 14.0–15.7 |
Moderate insomnia (ISI 15–21) | 1751 | 33 | 31.4–33.9 | 449 | 32 | 29.2–34.1 | 2200 | 32 | 31.3–33.5 |
Sub-threshold insomnia (ISI 8–14) | 1708 | 32 | 30.6–33.1 | 402 | 28 | 26.0–30.7 | 2110 | 31 | 30.0–32.2 |
No insomnia (ISI 0–7) | 1147 | 21 | 20.3–22.5 | 325 | 23 | 20.8–25.1 | 1472 | 22 | 20.7–22.7 |
Women | Men | Total | |||||
n | % | n | % | n | % | ||
Anxiety | Low risk of anxiety (HADS 0–7) | 2728 | 49 | 736 | 52 | 3491 | 49 |
Indicating risk of anxiety (HADS 8–10) | 1278 | 23 | 341 | 23 | 1619 | 23 | |
Probable risk of anxiety (HADS > 10) | 1615 | 29 | 368 | 25 | 1983 | 28 | |
Depression | Low risk of depression (HADS 0–7) | 3342 | 59 | 834 | 57 | 4176 | 59 |
Indicating risk of depression (HADS 8–10) | 1227 | 22 | 341 | 23 | 1568 | 22 | |
Probable risk of depression (HADS > 10) | 1056 | 19 | 298 | 20 | 1354 | 19 | |
Domains within SF-36 (0–100 points) | Mean Median | SD | Mean Median | SD | Mean Median | SD | |
Mental well-being | 61 64 | 20 | 62 64 | 21 | 62 64 | 20 | |
Social function | 50 50 | 24 | 54 50 | 25 | 51 50 | 24 | |
Physical function | 60 60 | 22 | 63 65 | 24 | 61 65 | 23 | |
Median | (q1, q3) | Median | (q1, q3) | Median | (q1, q3) | ||
Pain intensity (NRS 0–10) | 6 | (4, 7) | 5 | (3, 8) | 6 | (4, 7) |
Unadjusted Model | Adjusted for Confounders | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Variables | n | OR | 95% CI | p | Variables | n | Confounders | OR | 95% CI | p | ||
Pain intensity (ref: no improvement) | 6081 | ISI 4 ISI 3 ISI 2 ISI 1 | 0.99 1.03 0.98 1 | 0.81–1.19 0.86–1.23 0.81–1.19 | 0.901 | Pain intensity (ref: no improvement) | 6067 | Sex Country of birth | ISI 4 ISI 3 ISI 2 ISI 1 | 1.00 0.97 1.01 1 | 0.82–1.22 0.81–1.16 0.83–1.23 | 0.919 |
Physical function (ref: no improvement) | 6561 | ISI 4 ISI 3 ISI 2 ISI 1 | 1.50 1.30 1.39 1 | 1.25–1.79 1.10–1.53 1.16–1.67 | <0.001 | Physical function (ref: no improvement) | 5851 | Level of education | ISI 4 ISI 3 ISI 2 ISI 1 | 1.51 1.30 1.41 1 | 1.25–1.83 1.10–1.55 1.17–1.70 | <0.001 |
Social function (ref: no improvement) | 5925 | ISI 4 ISI 3 ISI 2 ISI 1 | 1.32 1.19 1.05 | 1.10–1.59 1.00–1.42 0.87–1.27 | 0.004 | Social function (ref: no improvement) | 5296 | Level of education | ISI 4 ISI 3 ISI 2 ISI 1 | 1.36 1.22 1.09 | 1.12–1.66 1.01–1.46 0.90–1.32 | 0.006 |
Mental well-being (ref: no improvement) | 6539 | ISI 4 ISI 3 ISI 2 ISI 1 | 1.77 1.40 1.16 | 1.48–2.11 1.18–1.65 0.97–1.39 | <0.001 | Mental well-being (ref: no improvement) | 5825 | Level of education | ISI 4 ISI 3 ISI 2 ISI 1 | 1.84 1.41 1.17 | 1.52–2.22 1.19–1.67 0.97–1.14 | <0.001 |
Anxiety (ref: no improvement) | 6567 | ISI 4 ISI 3 ISI 2 ISI 1 | 0.67 0.69 0.78 | 0.55–0.81 0.58–0.83 0.64–0.95 | <0.001 | Anxiety (ref: no improvement) | 5832 | Age Country of birth Level of education | ISI 4 ISI 3 ISI 2 ISI 1 | 0.69 0.72 0.80 | 0.56–0.85 0.59–0.87 0.65–0.98 | 0.002 |
Depression (ref: no improvement) | 6573 | ISI 4 ISI 3 ISI 2 ISI 1 | 0.59 0.70 0.90 | 0.48–0.72 0.57–0.85 0.72–1.15 | <0.001 | Depression (ref: no improvement) | 5837 | Age Sex Country of birth Level of education | ISI 4 ISI 3 ISI 2 ISI 1 | 0.63 0.73 0.92 | 0.50–0.78 0.59–0.90 0.73–1.15 | <0.001 |
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Lind, J.; Andréll, P.; Grimby-Ekman, A. Insomnia Symptoms and Chronic Pain among Patients Participating in a Pain Rehabilitation Program—A Registry Study. J. Clin. Med. 2021, 10, 4040. https://doi.org/10.3390/jcm10184040
Lind J, Andréll P, Grimby-Ekman A. Insomnia Symptoms and Chronic Pain among Patients Participating in a Pain Rehabilitation Program—A Registry Study. Journal of Clinical Medicine. 2021; 10(18):4040. https://doi.org/10.3390/jcm10184040
Chicago/Turabian StyleLind, Josefine, Paulin Andréll, and Anna Grimby-Ekman. 2021. "Insomnia Symptoms and Chronic Pain among Patients Participating in a Pain Rehabilitation Program—A Registry Study" Journal of Clinical Medicine 10, no. 18: 4040. https://doi.org/10.3390/jcm10184040
APA StyleLind, J., Andréll, P., & Grimby-Ekman, A. (2021). Insomnia Symptoms and Chronic Pain among Patients Participating in a Pain Rehabilitation Program—A Registry Study. Journal of Clinical Medicine, 10(18), 4040. https://doi.org/10.3390/jcm10184040