Factors Associated with Increased Risk for Clinical Insomnia in Patients with Chronic Neck Pain.

Pain Physician

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

Published: November 2015

AI Article Synopsis

  • Insomnia is prevalent in chronic neck pain (CNP) patients, significantly worsening pain, mood, and overall function, highlighting its impact on clinical outcomes.
  • A study analyzed 218 CNP patients, revealing that 22.9% had clinically significant insomnia, with high pain intensity, comorbid musculoskeletal pain, and depression identified as strong risk factors—particularly depression being a major predictor.
  • The research suggests that addressing insomnia is crucial in pain management for CNP patients, especially those with identified risk factors like depression.

Article Abstract

Background: Insomnia is highly prevalent among people with chronic pain conditions. Because insomnia has been shown to worsen pain, mood, and physical functioning, it could negatively impact the clinical outcomes of patients with chronic pain.

Objective: To determine the risk factors associated with clinical insomnia in chronic neck pain (CNP) patients.

Study Design: Retrospective analysis.

Setting: Outpatient department for interventional pain management at a university hospital.

Methods: Data from 218 CNP patients were analyzed in this study. The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ≥ 15). Patient demographics and pain-related factors were evaluated with logistic regression analysis to identify risk factors of clinical insomnia in CNP.

Results: In total, 53.7% of patients reported mild to severe insomnia after neck pain development; 22.9% of patients met the criteria for clinically significant insomnia (ISI score ≥ 15). In multivariate analysis, high pain intensity, the presence of comorbid musculoskeletal pain, and a high level of depression were strongly associated with clinical insomnia in patients with CNP. Among these factors, a greater level of depression was the strongest predictor of clinical insomnia, with the highest odds ratio of 3.689 (95% CI 1.570-8.667).

Limitations: This study was conducted in a single clinical setting including a selected study population with a homogeneous racial background. The ISI does not include several sleep-related variables, the roles of which are unknown in determining insomnia severity.

Conclusions: Insomnia should be addressed as an indispensable part of pain management in CNP patients with these risk factors, especially depression.

Clinical Trial: This study is a retrospective analysis. IRB No: 4-2014-0801.

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