Insomnia Really Hurts: Effect of a Bad Night's Sleep on Pain Increases With Insomnia Severity.

Yishul Wei,Eus J W Van Someren,Tessa F Blanken

doi:10.3389/fpsyt.2018.00377

Abstract

Insomnia and chronic pain are highly prevalent conditions and are often comorbid. Somatic complaints other than pain are also often observed in insomnia. Poor sleep and pain are known to mutually reinforce each other. However, it is unknown whether the habitual severity of insomnia modulates the acute effect of a particularly bad night's sleep on the next day's pain severity, and whether it modulates the acute effect of pain on the following night's sleep quality. Using data from 3,508 volunteers (2,684 female, mean age 50.09 y), we addressed these questions in addition to the associations between the habitual severity of insomnia, somatic complaints, and pain. Results indicated that people suffering from more severe habitual insomnia showed stronger mutual acute within-day reactivity of pain and poor sleep quality. The same increased reactivity was found in people with more severe habitual pain. Interestingly, the acute within-day mutual reactivity of pain and sleep quality showed consistent asymmetry. Pain worsened more after a particularly bad night's sleep than it improved after a particularly good night's sleep. Likewise, sleep worsened more after a day with more-than-usual pain than it improved after a day with less-than-usual pain. Future interventions may profit from addressing this asymmetric mutual reactivity especially in people with severe comorbid insomnia and chronic pain.

Highlights

Insomnia is the most prevalent sleep disorder and the second most prevalent mental disorder in Western countries [1]
The difference in habitual insomnia severity was secondary to the difference in sex distribution as the Insomnia Severity Index (ISI) within each sex did not differ between the subsamples
The strength of the perceived acute reciprocal effects is generally stronger in people with more severe habitual insomnia and pain, with the notable exception being that the benefit for sleep due to a day with less pain than usual is gradually lost with increasing habitual insomnia severity

Summary

Introduction

Insomnia is the most prevalent sleep disorder and the second most prevalent mental disorder in Western countries [1]. The prevalence of insomnia estimated by epidemiological studies ranges from 6% to one third, depending on the definition of insomnia and the source population [2]. Insomnia represents an important risk factor for the development of various medical conditions, including cardiovascular diseases [3, 4], diabetes [5], and other mental disorders [6]. Insomnia is often observed to accompany somatic complaints, including pain. Other somatic complaints besides pain have been linked to insomnia, such associations have been studied less extensively [14,15,16]

Methods

Results

Conclusion