Sleep difficulty, fatigue predictors of chronic widespread pain

Katarina Aili

AMSTERDAM — Fatigue coupled with sleep difficulties — including complications initiating sleep, maintaining sleep, early morning waking and nonrestorative sleep — predict the onset of chronic widespread pain after 5 years, according to findings presented at the EULAR Annual Congress.

“In population studies, approximately 10% of individuals report chronic widespread pain,” Katarina Aili, PhD, from the Spenshult Research and Development Center in Halmstad, Sweden, said during a press conference. “Chronic widespread pain is a complex that is associated with many negative health effects, as well as a high risk for both somatic illnesses and mental illnesses. Problems with sleep and fatigue are common concurrent problems among individuals reporting chronic widespread pain.”

To determine whether sleep difficulties and fatigue are predictors of later chronic widespread pain, Aili and colleagues examined individuals who had not reported chronic widespread pain at baseline or during the preceding 3 years, entering them into 5-year (n=1,249) and 18-year (n=791) follow-up analysis groups.

The researchers evaluated four parameters related to sleep and one parameter related to fatigue, and determined that among the analysis groups, 785 individuals did not report any of sleeping difficulties at baseline, 268 reported only one of the sleep problems, 167 individuals reported two, 128 reported three and 117 individuals described having all four sleep problems.

Study results demonstrated that individuals who reported all four sleeping difficulties at baseline compared with those who reported no sleep problems were significantly more likely to exhibit chronic widespread pain at 5-year and 18-year follow-up analysis.

At EULAR 2018, Katarina Aili, PhD, discussed recent findings that fatigue coupled with sleep difficulties — including complications initiating sleep, maintaining sleep, early morning waking and nonrestorative sleep — predicted the onset of chronic widespread pain after 5 years.

Credit: Healio.com

After adjusting for age, gender, socioeconomy and mental health, the researchers determined that all investigated parameters predicted the onset of chronic widespread pain 5 years later: difficulty initiating sleep (OR = 1.91; 95% CI, 1.16-3.14); maintaining sleep (OR = 1.85; 95% CI, 1.14-3.01); early awakening (OR = 2; 1.37-3.75); nonrestorative sleep (OR = 2.27; 95% CI, 1.37-3.75); and fatigue (OR = 3.7; 95% CI, 1.76-7.84).

Additionally, Aili and colleagues observed that these same parameters also predicted the onset of chronic widespread pain after 18 years, with the exception of early awakening.

“Sleep does seem to be an important marker for pain prognosis among these patients, and it seems to indicate pain prognosis also over very long periods of time,” Aili said. “We believe it is important to attend to sleep problems in the care of patients with chronic musculoskeletal pain.”– by Bob Stott

Reference:
Aili K, et al. Abstract OP0072. Presented at: EULAR Annual Congress; June 13-16, 2018; Amsterdam.

Disclosure: Aili reports no relevant financial disclosures.