Prevalencia de dolor como motivo de consulta y su influencia en el sueño: experiencia en un centro de atención primaria

Abstract

Objectives To determine the frequency of pain as a reason to visit a Primary Care doctor and to investigate the influence of pain on sleep disturbances. Design Cross-sectional descriptive study. Setting Urban Primary Health Care Centre. Participants The first five patients who came to the primary health care centre with an appointment were included. Those who came with pain were labelled as cases, the others as controls. Main measurements Socio-demographic variables, background, use of co-analgesics, Pittsburgh Sleep Quality Index (a global PSQI score greater than 5 indicated “poor sleepers”). For the cases, pain intensity was also assessed, chronology and kind of pain, the system affected and treatment. Results A total of 206 patients were included and 31 excluded. The mean age was 50 years and 56% were women. Pain was the reason for consultation in 39% of the patients, of whom 78% had acute pain, 80% nociceptive, 75% incidental and 71% musculoskeletal. The average VAS score was 4.98. A total of 62% were receiving treatment according to the first step of the WHO pain ladder. Forty-five per cent of patients were categorized as “good sleepers”. The multivariate analysis showed that acute pain ( P = .022) and pain intensity ( P = .035) in men appeared as independent factors of sleep disturbances; in women there were no statistically significant variables. Conclusions In our study, a high percentage of patients came to the primary health care centre for pain, mainly musculoskeletal. In men, there is a clear relationship between sleep disturbances, pain intensity and acute pain. Further research is needed to study this topic in depth, in order to alleviate pain and improve the sleep quality in our patients.