Abstract
Chronic pain due to osteoarthritis (OA) can lead to significant disruption of sleep and increased restlessness. Our objective was to assess whether naturally occurring canine OA is associated with nighttime restlessness and so has potential as a model of OA-associated sleep disturbance. The study was designed as a two-part prospective masked, placebo-controlled study using client-owned dogs (Part A n = 60; Part B n = 19). Inclusion criteria consisted of OA-associated joint pain and mobility impairment. The primary outcome measure for both parts was nighttime accelerometry. In Part B, quality of sleep was assessed using a clinical metrology instrument (Sleep and Night Time Restlessness Evaluation Score, SNoRE). Part A included dogs receiving two weeks of non-steroidal anti-inflammatory drug (NSAID) preceded with two weeks of no treatment. Part B was a crossover study, with NSAID/placebo administered for two weeks followed by a washout period of one week and another two weeks of NSAID/placebo. Repeated measures analysis of variance was used to assess differences between baseline and treatment. There were no significant changes in accelerometry-measured nighttime activity as a result of NSAID administration. SNoRE measures indicated significant improvements in aspects of the quality of nighttime sleep that did not involve obvious movement. These results reflect the few similar studies in human OA patients. Although accelerometry does not appear to be useful, this model has potential to model the human pain-related nighttime sleep disturbance, and other outcome measures should be explored in this model.
Highlights
The annual economic cost of chronic pain in the United States is estimated to be $560–635 billion, with arthritis accounting for approximately $190 billion (1/3rd) of that total (Medicine, 2011)
The aim of our study was to perform preliminary investigations into whether naturally occurring canine OA is associated with nighttime restlessness as assessed using accelerometry and a clinical metrology instrument, and whether this might be a potential model of OA-associated sleep disturbance in humans
The SNoRE clinical metrology instrument did detect a subjective improvement in sleep with the provision of analgesia, indicating that quality of sleep is disturbed in naturally occurring OA in dogs due to pain
Summary
The annual economic cost of chronic pain in the United States is estimated to be $560–635 billion, with arthritis accounting for approximately $190 billion (1/3rd) of that total (Medicine, 2011). How to cite this article Knazovicky et al (2015), Initial evaluation of nighttime restlessness in a naturally occurring canine model of osteoarthritis pain. Our report describes the initial evaluation of a naturally occurring animal model of arthritis as a model of arthritis-induced sleep disturbance. One-third to half of those people with painful arthritis suffer from sleep disturbances (Moldofsky, Lue & Saskin, 1987; Power, Perruccio & Badley, 2005; Wilcox et al, 2000; Woolhead et al, 2010; Taylor-Gjevre et al, 2011) often associated with restlessness (Leigh et al, 1988). A recent focus group study highlighted the importance of night pain in human osteoarthritis (OA), and the relative lack of studies on night pain (Woolhead et al, 2010)
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