Lack of sleep quality in older adults with chronic pain

Category: Blog

The importance of sleep in managing chronic pain

Recently we reported on medical research that suggests that treating patients for sleep problems would help manage their chronic pain. One study at  John Hopkins suggested that chronic pain sufferers who learn to dwell less on their ailments may sleep better and experience less day-to-day pain. The research was conducted on 214 people with chronic face and jaw pain.

“We have found that people who ruminate about their pain and have more negative thoughts about their pain don’t sleep as well, and the result is they feel more pain,” says Luis F. Buenaver, Ph.D., an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and the leader of a study published online in the journal Pain. “If cognitive behavioral therapy can help people change the way they think about their pain, they might end that vicious cycle and feel better without sleeping pills or pain medicine.”

The importance of a supportive partner

In a new study from July 2015, doctors at the  National Institutes of Health examined the  effect of daily negative and positive mood on the sleep quality of knee osteoarthritis patientsand whether a partner’s daily responses to a patient’s pain behaviors moderated these associations.

Patients and their partners completed a baseline interview and 22 daily diary assessments. After controlling for demographic characteristics, osteoarthritis, comorbidities, medication use, relationship satisfaction, and depressed mood, multilevel modeling analyses demonstrated main effects of negative and positive mood on sleep quality indicators.

Mood and partner responses interacted such that high solicitous and punishing responses strengthened the association between negative mood and worse sleep. Further, high solicitous responses increased the degree of association between low positive mood and poor sleep, and empathic responses combined with positive mood were associated with better sleep. Results demonstrate that daily negative and positive mood fluctuations can interact with partner responses to affect sleep quality among older adults with chronic pain.

 

The importance of vitamin D

The emergence of new data suggests that the benefits of Vitamin D extend beyond healthy bones. In this new research from doctors in New Zealand looked at Vitamin D and its role in chronic pain states and associated comorbidities.

The paper shows that Vitamin D exerts anatomic, hormonal, neurological, and immunological influences on pain manifestation, thereby playing a role in the aetiology and maintenance of chronic pain states and associated comorbidities. There appears to be considerable overlap in the effects of sleep, pain, depression, and Vitamin D on the immune system.2

Researchers writing in the Clinical Journal of Painmade a connection with sleep and the effects of vitamin D supplementation in outpatient veterans with multiple areas of chronic pain.

Here is what they did: A total of 28 US veterans with multiple areas of chronic pain and low serum 25-hydroxyvitamin D [25(OH)D]

They were supplemented with vitamin D 1200 IU daily if serum 25(OH)D was in the insufficient range (20 to 29 ng/mL) or 50,000 IU weekly if serum 25(OH)D was in the deficient range.

Participants reported no side effects during the study. Relative to baseline, pain, sleep, and QoL all improved except for role-functioning emotional. The improvements remained significant in pain score, sleep latency, sleep duration, bodily pain, general health, vitality, and social functioning.

“Standardized vitamin D supplementation in veterans with multiple areas of chronic pain can be effective in improving their pain levels, sleep, and various aspects of Quality of Life.”

 

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1. Song S, Graham-Engeland JE, Mogle J, Martire LM. The effects of daily mood and couple interactions on the sleep quality of older adults with chronic pain. J Behav Med. 2015 Jul 5. [Epub ahead of print]

2. Shipton EA, Shipton EE. Vitamin D and Pain: Vitamin D and Its Role in the Aetiology and Maintenance of Chronic Pain States and Associated Comorbidities. Pain Res Treat. 2015;2015:904967. doi: 10.1155/2015/904967. Epub 2015 Apr 19.