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Prevalence and correlates of clinical insomnia co‐occurring with chronic back pain
Abstract
Summary: Given the suggestion of a reciprocal relationship between sleep and pain and the recognition of sleep as an important parameter in determining quality of life, there is increasing research interest in sleep disturbance linked to chronic pain. The present study aimed to provide an estimate of the prevalence of ‘clinical insomnia’ in patients attending a specialist pain clinic and identify factors associated with it. Seventy chronic back pain patients and 70 gender‐ and age‐matched pain‐free controls completed a set of questionnaires measuring sleep (Insomnia Severity Index; ISI), pain (Short‐Form McGill Pain Questionnaire) and a selection of general and specific psychological variables (Hospital Anxiety and Depression Scale, Short Health Anxiety Inventory). Scores suggestive of clinical insomnia (ISI ≥ 15) were noted in 53% of chronic pain patients, when compared with only 3% in pain‐free controls. Significant positive correlations with insomnia severity were detected for all six variables of interest (pain intensity, sensory pain ratings, affective pain ratings, general anxiety, general depression and health anxiety). Affective pain ratings and health anxiety were the best predictors of insomnia severity in this sample, accounting for 30% of the total variance, even when present pain intensity was controlled for. Affective pain remained as a significant predictor of insomnia severity when both the effect of pain intensity and the effects of anxiety and depression were controlled for. Future research should consider investigating the role of pain appraisal and health anxiety in the development and manifestation of insomnia concomitant to chronic pain.
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“Moderate to severe insomnia (score ≥ 15) according to the Insomnia Severity Index (ISI) is frequently (53–65%) reported among patients with chronic pain [2–4].”
From Is sleep disturbance in patients with chronic pain affected by physical exercise or ACT-based stress management? - A randomized controlled study (2018) · cites this paper as [3]
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Sun, H., Li, Z., Qiu, Z., Shen, Y., Guo, Q., Hu, S.-W., Ding, H., An, S., & Cao, J. (2023) · Nature Communications · doi:10.1038/s41467-023-40450-3 · Cited by 53
Metadata
- Authors
- TANG, N. K. Y., WRIGHT, K. J., & SALKOVSKIS, P. M.
- Affiliations
- King's College London (GB)
- Corresponding author
- TANG, NICOLE K. Y.
- Venue
- Journal of Sleep Research
- Publisher
- Wiley
- Published
- 2007-02-19
- Volume
- 16
- Issue
- 1
- Pages
- 85-95
- ISSN
- 0962-1105 (ISSN-L)
- 1365-2869
- OpenAlex
- W1977069267
- Cited by
- 383
- References
- 73
- Citations by year
- 2026: 13 · 2025: 12 · 2024: 21 · 2023: 33 · 2022: 32 · 2021: 41 · 2020: 17 · 2019: 20 · 2018: 11 · 2017: 20 · 2016: 27 · 2015: 29 · 2014: 17 · 2013: 20 · 2012: 21
- FWCI
- 11.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Sleep Research (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- chronic back pain, insomnia prevalence, insomnia severity, affective pain, health anxiety, anxiety, depression, pain intensity, sleep-pain relationship, pain appraisal, quality of life, pain clinic patients
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Back Pain, Chronic Disease, Depressive Disorder, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Pain Measurement, Surveys and Questionnaires, Severity of Illness Index, Comorbidity, Prevalence, Diagnostic and Statistical Manual of Mental Disorders
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