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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 3/2017

01-06-2017 | Original Article

Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects

Authors: James I. Gerhart, PhD, John W. Burns, PhD, Kristina M. Post, PhD, David A. Smith, PhD, Laura S. Porter, PhD, Helen J. Burgess, PhD, Erik Schuster, MA, Asokumar Buvanendran, MD, Anne Marie Fras, MD, Francis J. Keefe, PhD

Published in: Annals of Behavioral Medicine | Issue 3/2017

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Abstract

Background

Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function, and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day.

Purpose

This daily diary study examined lagged temporal associations between prior night sleep quality and subsequent day pain, affect, physical function and pain catastrophizing, the reverse lagged temporal associations between prior day pain-related factors and subsequent night sleep quality, and whether the time of day during which an assessment was made moderated these temporal associations.

Methods

Chronic low back pain patients (n = 105) completed structured electronic diary assessments five times per day for 14 days. Items included patient ratings of their pain, affect, physical function, and pain catastrophizing.

Results

Collapsed across all observations, poorer sleep quality was significantly related to higher pain ratings, higher negative affect, lower positive affect, poorer physical function, and higher pain catastrophizing. Lagged analyses averaged across the day revealed that poorer prior night sleep quality significantly predicted greater next day patient ratings of pain, and poorer physical function and higher pain catastrophizing. Prior poorer night sleep quality significantly predicted greater reports of pain, and poorer physical function, and higher pain catastrophizing, especially during the early part of the day. Sleep quality × time of day interactions showed that poor sleepers reported high pain, and negative mood and low function uniformly across the day, whereas good sleepers reported relatively good mornings, but showed pain, affect and function levels comparable to poor sleepers by the end of the day. Analyses of the reverse causal pathway were mostly nonsignificant.

Conclusions

Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night’s sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping.
Literature
1.
Smith MT, Haythornthwaite JA. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004; 8(2):119–32.CrossRefPubMed
2.
Tang NK, Wright KJ, Salkovskis PM. Prevalence and correlates of clinical insomnia co-occurring with chronic back pain. J Sleep Res. 2007; 16(1):85–95.CrossRefPubMed
3.
4.
Alsaadi SM, Mcauley JH, Hush JM, et al. The bidirectional relationship between pain intensity and sleep disturbance/quality in patients with low back pain. Clin J Pain. 2014; 30(9):755–65.CrossRefPubMed
5.
Tang NK, Goodchild CE, Sanborn AN, Howard J, Salkovskis PM. Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: a multilevel daily process study. Sleep. 2012; 35(5):675-87A.PubMedPubMedCentral
6.
Lewandowski AS, Palermo TM, De la Motte S, Fu R. Temporal daily associations between pain and sleep in adolescents with chronic pain versus healthy adolescents. Pain. 2010; 151(1):220–5.CrossRefPubMedPubMedCentral
7.
O’brien EM, Waxenberg LB, Atchison JW, et al. Negative mood mediates the effect of poor sleep on pain among chronic pain patients. Clin J Pain. 2010; 26(4):310–9.CrossRefPubMed
8.
O'brien EM, Waxenberg LB, Atchison JW, et al. Intraindividual variability in daily sleep and pain ratings among chronic pain patients: bidirectional association and the role of negative mood. Clin J Pain. 2011; 27(5):425–33.CrossRefPubMed
9.
Affleck G, Urrows S, Tennen H, Higgins P, Abeles M. Sequential daily relations of sleep, pain intensity, and attention to pain among women with fibromyalgia. Pain. 1996; 68(2–3):363–8.CrossRefPubMed
10.
Jamison RN, Brown GK. Validation of hourly pain intensity profiles with chronic pain patients. Pain. 1991; 45(2):123–8.CrossRefPubMed
11.
Kothari DJ, Davis MC, Yeung EW, Tennen HA. Positive affect and pain: mediators of the within-day relation linking sleep quality to activity interference in fibromyalgia. Pain. 2015; 156(3):540–6.CrossRefPubMed
12.
First MB, Spitzer RL, Gibbon M, Williams JBW. Structured clinical interview for DSM-IV Axis I Disorders-Non-patient edition (SCID-I/NP, Version 2.0). New York: Biometrics Research Department; 1996.
13.
Stone AA, Shiffman S. Ecological momentary assessment (EMA) in behavioral medicine. Annals of Behavioral Medicine. 1994; 16:199–202.
14.
Cruise CE, Broderick J, Porter L, Keall A, Stone AA. Reactive effects of diary self-assessment in chronic pain patients. Pain. 1996; 67:253–258.CrossRefPubMed
15.
Jamison RN, Raymond SA, Levine JG, Slawsby EA, Nedeljkovic SS, Katz NP. Electronic diaries for monitoring chronic pain: 1 year validation study. Pain. 2001; 91:277–285.CrossRefPubMed
16.
Peters ML, Sorbi MJ, Kruise DA, Kerssens JJ, Verhaak PFM, Bensing JM. Electronic diary assessment of pain, disability and psychological adaptation in patients differing in duration of pain. Pain. 2000; 84:181–192.CrossRefPubMed
17.
Barrett LF, Barrett DJ. An introduction to computerized experience sampling in psychology. Social Science Computer Review. 2001; 19(2):175–185.CrossRef
18.
Cranford JA, Shrout PE, Iida M, Rafaeli E, Yip T, Bolger N. A procedure for evaluating sensitivity to within-person change: can mood measures in diary studies detect change reliably?. Pers Soc Psychol Bull. 2006; 32(7):917–29.CrossRefPubMedPubMedCentral
19.
Rosenstiel AK, Keefe FJ. The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain. 1983; 17(1):33–44.CrossRefPubMed
20.
Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annual Review of Clinical. Psychology. 2008; 4, 1–32.CrossRefPubMed
21.
Selya AS, Rose JS, Dierker LC, Hedeker D, Mermelstein RJ. A practical guide to calculating Cohen’s f(2), a measure of local effect size, from PROC MIXED. Front Psychol. 2012; 3:111.CrossRefPubMedPubMedCentral
22.
Preacher KJ, Curran PJ, Bauer DJ. Computational tools for probing interaction effects in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics. 2006; 31, 437–448.CrossRef
23.
Büyükyilmaz FE, Şendir M, Acaroğlu R. Evaluation of night-time pain characteristics and quality of sleep in postoperative Turkish orthopedic patients. Clin Nurs Res. 2011; 20(3):326–42.CrossRefPubMed
24.
Finan PH, Buenaver LF, Coryell VT, Smith MT. Cognitive-behavioral therapy for comorbid insomnia and chronic pain. Sleep Med Clin. 2014; 9(2):261–274.CrossRefPubMedPubMedCentral
25.
Pigeon WR, Moynihan J, Matteson-rusby S, et al. Comparative effectiveness of CBT interventions for co-morbid chronic pain & insomnia: a pilot study. Behav Res Ther. 2012; 50(11):685–9.CrossRefPubMedPubMedCentral
26.
Vitiello MV, Mccurry SM, Shortreed SM, et al. Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial. J Am Geriatr Soc. 2013; 61(6):947–56.CrossRefPubMedPubMedCentral
Metadata
Title
Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects
Authors
James I. Gerhart, PhD
John W. Burns, PhD
Kristina M. Post, PhD
David A. Smith, PhD
Laura S. Porter, PhD
Helen J. Burgess, PhD
Erik Schuster, MA
Asokumar Buvanendran, MD
Anne Marie Fras, MD
Francis J. Keefe, PhD
Publication date
01-06-2017
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 3/2017
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-016-9860-2

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