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

 Shin Hyung Kim  ;  Dong Hoon Lee  ;  Kyung Bong Yoon  ;  Jong Rin An  ;  Duck Mi Yoon 
 PAIN PHYSICIAN, Vol.18(6) : 593-598, 2015 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Anxiety/etiology ; Anxiety/psychology ; Chronic Pain ; Depression/etiology ; Depression/psychology ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Pain/complications ; Neck Pain/complications* ; Neck Pain/epidemiology ; Neck Pain/psychology ; Pain Management ; Prevalence ; Retrospective Studies ; Risk Factors ; Sleep Initiation and Maintenance Disorders/epidemiology ; Sleep Initiation and Maintenance Disorders/etiology* ; Sleep Initiation and Maintenance Disorders/psychology ; Young Adult
Chronic neck pain ; insomnia ; risk factors ; pain severity ; neuropathic pain ; musculoskeletal pain ; depression
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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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
An, Jong Rin(안종린)
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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