BOSTON—Insomnia comorbid with chronic pain was associated with the most severe insomnia symptoms, compared with insomnia comorbid with depression and primary insomnia, according to research presented at the 26th Annual Meeting of the Associated Professional Sleep Societies.
After adjusting for age, sex, ethnicity, and education, investigators found that wake after sleep onset (WASO) averaged nearly 300 minutes per week for patients who had insomnia comorbid with chronic pain. WASO was approximately 180 minutes per week for patients who had insomnia comorbid with depression and for patients with primary insomnia, said Elizabeth A. Waldron, MS, a doctoral student at the Philadelphia College of Osteopathic Medicine.
Sleep latency averaged approximately 420 minutes per week for patients with insomnia comorbid with chronic pain. Sleep latency was approximately 390 minutes per week for individuals with insomnia comorbid with depression, and approximately 330 minutes per week for patients with primary insomnia.
An Online Survey of Insomnia Symptoms
Ms. Waldron and colleagues used an online questionnaire to assess self-reported insomnia severity symptoms between patients with primary insomnia and those who had insomnia comorbid with chronic pain or depression. Participants provided data about demographics, standard sleep variables, insomnia-related daytime impairment, sleep sufficiency, pain, depression, and other health variables.
Patient information was used to calculate sleep latency, WASO, overall insomnia severity, and total sleep time. Insomnia was defined as sleep latency or WASO greater than 30 minutes three times per week and a self report of daytime impairment. The researchers analyzed the data through linear regression using insomnia variables as predictors.
Insomnia, Depression, and Chronic Pain
A total of 936 participants were good sleepers, 731 had primary insomnia, 372 had insomnia comorbid with chronic pain, and 638 had insomnia comorbid with depression. Approximately 60% of participants were female, and about 67% were white. Participants’ average age was 36.
Self-reported sleep latency severity was 424.41 minutes per week for patients who had insomnia comorbid with depression, 370.81 minutes per week for patients who had insomnia comorbid with chronic pain, 318.07 minutes per week for patients with primary insomnia, and 69.14 minutes per week for good sleepers.
Self-reported WASO severity was 279.49 minutes per week for patients who had insomnia comorbid with depression, 170.31 minutes per week for patients who had insomnia comorbid with chronic pain, 160.91 minutes per week for patients with primary insomnia, and 25.49 minutes per week for good sleepers.
“We look at these as only preliminary results, because we only used self-report measures at one time point to measure both insomnia symptoms and self-reported diagnoses of pain and depression,” Ms. Waldron told Neurology Reviews. “Further research is needed into the long-term effects of comorbid pain and depression on insomnia symptoms in the general population.”
—Erik Greb