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Factors Associated with Increased Risk for Clinical Insomnia in Patients with Postherpetic Neuralgia: A Retrospective Cross-Sectional Study

 Dong Hoon Lee  ;  Ji Eun Park  ;  Duck Mi Yoon  ;  Kyung Bong Yoon  ;  Kiwook Kim  ;  Shin Hyung Kim 
 PAIN MEDICINE, Vol.17(10) : 1917-1922, 2016 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Neuralgia, Postherpetic/diagnosis* ; Neuralgia, Postherpetic/epidemiology* ; Neuralgia, Postherpetic/therapy ; Pain Management/methods* ; Retrospective Studies ; Risk Factors ; Sleep Initiation and Maintenance Disorders/diagnosis* ; Sleep Initiation and Maintenance Disorders/epidemiology* ; Sleep Initiation and Maintenance Disorders/therapy ; Young Adult
Allodynia ; Anxiety ; Depression ; Insomnia ; Neuropathic Pain ; Postherpetic Neuralgia
OBJECTIVE: To determine the risk factors associated with clinical insomnia in postherpetic neuralgia (PHN) patients. DESIGN: A retrospective cross-sectional study. SETTING: Outpatient department for interventional pain management at a university hospital. SUBJECTS: A total of 111 patients with PHN satisfied the study inclusion criteria and were included in the analyses. METHODS: The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score?≥?15). Patient demographics, pain-related factors, and rash severity and location were evaluated with logistic regression analysis to identify risk factors of clinical insomnia among patients with PHN. RESULTS: In total, 50.5% of patients reported mild to severe insomnia symptoms (ISI score?≥ 8) after pain development. Moderate to severe clinical insomnia (ISI score?≥ 15) was observed in 30.6% of PHN patients. Multivariate logistic regression analyses revealed that high pain intensity was the strongest predictor of clinical insomnia (odds ratio (OR) = 12.417, 95% confidence interval (CI): 2.990-51.561, P = 0.001). However, presence of mechanical allodynia (OR?=?4.263, 95% CI: 1.040-17.481, P = 0.034) and high anxiety and depression level (OR?=?4.452, 95% CI: 1.201-16.508, P = 0.026; OR?=?6.975, 95% CI: 1.425-34.138, P = 0.017) were also significantly associated with clinical insomnia after adjusting for pain score. Clinical insomnia was not significantly related to age, gender, rash severity, or location of skin lesion. CONCLUSIONS: Insomnia should be addressed as an important part of pain management in PHN patients with these risk factors, especially in patients with severe pain.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Shin Hyung(김신형) ORCID logo https://orcid.org/0000-0003-4058-7697
Park, Ji Eun(박지은)
Yoon, Kyoung Bong(윤경봉) ORCID logo https://orcid.org/0000-0002-4167-1375
Yoon, Duck Mi(윤덕미)
Lee, Dong Hoon(이동훈)
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