Pain-related insomnia versus primary insomnia: a comparison study of sleep pattern, psychological characteristics, and cognitive-behavioral processes
The Clinical Journal of Pain, 05/16/2012
Tang NKY et al. – There are more similarities than differences between the 2 types of insomnia. Besides pain, mood, and presleep, thought processes also seem to have a role in the manifestation of pain–related insomnia. It is suggested that hybrid treatments that seek to simultaneously address factors across these domains may represent more effective treatments than 1–dimensional interventions.Methods
- Chronic pain patients with concomitant insomnia (n=137; Pain–related Insomnia Group) completed a selection of questionnaires that measure sleep patterns, psychological attributes, and cognitive–behavioral processes associated with the persistence of insomnia.
- Their responses were compared with those of primary insomnia patients (n=33; Primary Insomnia Group), using 3 sets of multivariate analyses of covariance that took account of demographic differences.
- Hierarchical regression analyses were performed to identify predictors of insomnia severity among the chronic pain patients.
- The Pain–related Insomnia Group did not differ from the Primary Insomnia Group in their pattern and severity of sleep disturbance.
- The 2 groups were largely comparable in terms of their psychological characteristics, except that the Primary Insomnia Group was distinguishable from the Pain–related Insomnia Group by their greater tendency to worry.
- Patients in the Pain–related Insomnia Group reported levels of sleep–related anxiety and presleep somatic arousal that matched with those reported by patients in the Primary Insomnia Group.
- However, relative to patients in the Pain–related Insomnia Group, those in the Primary Insomnia Group reported more dysfunctional sleep beliefs and presleep cognitive arousal.
- In addition to pain intensity, depression, and presleep cognitive arousal were significant predictors of insomnia severity within the Pain–related Insomnia Group.