RESEARCH - Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study

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Rheumatology Advance Access published online on October 7, 2008

Rheumatology, doi:10.1093/rheumatology/ken389

Restorative sleep predicts the resolution of chronic widespread pain:

results from the EPIFUND study

K. A. Davies1, G. J. Macfarlane2, B. I. Nicholl1, C. Dickens3, R.

s4, D. Ray5 and J. McBeth1

1Arthritis Research Campaign (ARC) Epidemiology Unit, School of

Epidemiology and Health Sciences, University of Manchester, Manchester

2Aberdeen Pain Research Collaboration (Epidemiology Group), Department

of Public Health, University of Aberdeen, School of Medicine, Aberdeen

3Department of Psychiatry, The University of Manchester, Manchester

4Division of Psychiatry, University of Nottingham, Nottingham

5Endocrine Sciences Research Group, University of Manchester,

Manchester, UK.

Abstract

Objectives. Poor sleep is associated with chronic widespread pain

(CWP). Conversely, good-quality sleep may play a role in the

resolution of pain symptoms. Sleep is a multidimensional construct,

comprising a number of diverse components. The aims of the current

study were to examine the hypotheses that: (i) good sleep quality

would predict the resolution of CWP, (ii) restorative sleep would

predict the resolution of CWP and (iii) that these relationships would

be independent of confounding psychological factors.

Methods. Subjects in a population-based prospective study completed a

pain questionnaire at baseline from which subjects with CWP were

identified. Baseline sleep was measured using the Estimation of Sleep

Problems Scale which measures sleep onset, maintenance, early wakening

and restorative sleep. The questionnaire also contained scales

examining psychosocial status. Subjects were followed up 15 months

later and pain status was assessed.

Results. A total of 1061 subjects reported CWP at baseline of whom 679

(75% of eligible subjects) responded at follow-up. Of those, a total

of 300 (44%) no longer satisfied criteria for CWP. Univariate analysis

revealed that three of the four sleep components were associated with

the resolution of CWP: rapid sleep onset, odds ratio (OR) = 1.7, 95%

CI 1.2, 2.5; absence of early wakening, OR = 1.6, 95% CI 1.1, 2.4; and

restorative sleep, OR = 2.7, 95% CI 1.5, 4.8. After adjusting for the

effect of psychosocial factors, which may have confounded the

relationship, only restorative sleep (OR = 2.0, 95% CI 1.02, 3.8) was

associated.

Conclusions. Self-reported restorative sleep was independently

associated with the resolution of CWP and return to musculoskeletal

health.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken389v1?papetoc

Not an MD

[Guest guest]

Thank you for this helpful article !

Debbie L

>

> Rheumatology Advance Access published online on October 7, 2008

> Rheumatology, doi:10.1093/rheumatology/ken389

>

>

> Restorative sleep predicts the resolution of chronic widespread

pain:

> results from the EPIFUND study

>

>

> K. A. Davies1, G. J. Macfarlane2, B. I. Nicholl1, C. Dickens3, R.

> s4, D. Ray5 and J. McBeth1

> 1Arthritis Research Campaign (ARC) Epidemiology Unit, School of

> Epidemiology and Health Sciences, University of Manchester,

Manchester

> 2Aberdeen Pain Research Collaboration (Epidemiology Group),

Department

> of Public Health, University of Aberdeen, School of Medicine,

Aberdeen

> 3Department of Psychiatry, The University of Manchester, Manchester

> 4Division of Psychiatry, University of Nottingham, Nottingham

> 5Endocrine Sciences Research Group, University of Manchester,

> Manchester, UK.

>

>

>

> Abstract

>

>

> Objectives. Poor sleep is associated with chronic widespread pain

> (CWP). Conversely, good-quality sleep may play a role in the

> resolution of pain symptoms. Sleep is a multidimensional construct,

> comprising a number of diverse components. The aims of the current

> study were to examine the hypotheses that: (i) good sleep quality

> would predict the resolution of CWP, (ii) restorative sleep would

> predict the resolution of CWP and (iii) that these relationships

would

> be independent of confounding psychological factors.

>

> Methods. Subjects in a population-based prospective study completed

a

> pain questionnaire at baseline from which subjects with CWP were

> identified. Baseline sleep was measured using the Estimation of

Sleep

> Problems Scale which measures sleep onset, maintenance, early

wakening

> and restorative sleep. The questionnaire also contained scales

> examining psychosocial status. Subjects were followed up 15 months

> later and pain status was assessed.

>

> Results. A total of 1061 subjects reported CWP at baseline of whom

679

> (75% of eligible subjects) responded at follow-up. Of those, a total

> of 300 (44%) no longer satisfied criteria for CWP. Univariate

analysis

> revealed that three of the four sleep components were associated

with

> the resolution of CWP: rapid sleep onset, odds ratio (OR) = 1.7, 95%

> CI 1.2, 2.5; absence of early wakening, OR = 1.6, 95% CI 1.1, 2.4;

and

> restorative sleep, OR = 2.7, 95% CI 1.5, 4.8. After adjusting for

the

> effect of psychosocial factors, which may have confounded the

> relationship, only restorative sleep (OR = 2.0, 95% CI 1.02, 3.8)

was

> associated.

>

> Conclusions. Self-reported restorative sleep was independently

> associated with the resolution of CWP and return to musculoskeletal

> health.

>

>

>

http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken389v1?

papetoc

>

>

>

> Not an MD

>

[Guest guest]

Wow - Ain't that the truth!! I have Chronic Obstructive Sleep Apnea

and have to use a CPAP machine, so my sleep is semi-disrupted anyway.

Then add into that the CWP from the RA and FMS and its no wonder I

have troubles sleeping at times and wake feeling not rested. When I DO

get a good nights sleep, I don't feel as bad in the mornings.

Unfortunately, that doesn't happen very often.........Doreen

>

>

> Restorative sleep predicts the resolution of chronic widespread

> pain: results from the EPIFUND study

>

> Conclusions. Self-reported restorative sleep was independently

> associated with the resolution of CWP and return to musculoskeletal

> health.

>

> http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken389v1?

> papetoc

>

>

>

> Not an MD

>

>