Sleep disturbances should be addressed in the assessment and treatment of chronic pain as a unique component to both pain and physical function, according to a study of 101 patients with chronic pain. Researchers found:

• 75.2% of participants had insomnia and 84.3% reported the presence of at least 1 sleep problem.

• Significant positive correlations with pain were detected for depression, catastrophizing, insomnia, short sleep duration and poor sleep quality.

• Sleep duration had a significant independent association with pain after accounting for depression and catastrophizing.

• Sleep duration had an independent association with physical function after accounting for pain and catastrophizing.

Citation: Roberts MB, Drummond PD. Sleep problems are associated with chronic pain over and above mutual associations with depression and catastrophizing. [Published online ahead of print December 24, 2015]. Clin J Pain. doi: 10.1097/AJP.0000000000000329.

Commentary: Sleep disturbance is common and has been associated in the general population with an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke. Almost 20% of serious car accidents in the general population are associated with driver sleepiness.¹ It makes sense that patients with chronic pain may also suffer from sleep disturbance. The challenge is how to address this problem, but there is no question that this study is helpful in clarifying that the first step in addressing a problem is knowing it exists. —Neil Skolnik, MD