Sleep Quality in Chronic Neck Pain Patients
Main Article Content
Abstract
Introduction: Neck Pain (NP) is a significant public health issue. Many people's social and economic participation is harmed as a result of NP. Patients with this condition frequently complain of fatigue and pain. Both can disrupt patients' daily lives by affecting their sleep quality, which can lead to psychological issues. However, the prevalence of fatigue and its relationship with pain, sleep quality, and psychological factors in NP patients has not been thoroughly investigated.
Aim: To investigate the prevalence of fatigue and its relationship to pain intensity, depression, anxiety, and sleep disturbance in NP patients.
Materials and Methods: Between March and November 2019, a cross-sectional study of 296 NP patients with a mean age of 37.2 years (181 males and 115 females) was conducted. It was held at the Physiotherapy Department. To assess fatigue, depression and anxiety, sleep quality, and pain intensity, the Multidimensional Fatigue Inventory (MFI), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Numeric Pain Rating Scale (NPRS) were used. For analysis, Spearman's rank correlation coefficient and the Mann-Whitney U test were used.
Results: The participants' point prevalence of severe fatigue was 39.86%. Pain intensity, psychological factors, and sleep quality were all associated with fatigue (p0.05). In this sample, we also found a significant relationship between sleep quality and psychological factors (p0.05).
Conclusion: Fatigue was a significant factor in NP patients, and it was linked to pain intensity, depression, anxiety, and sleep disturbance. Fatigue was more prevalent in the chronic stage of NP than in the acute stage. Identifying these risk factors may aid in the prevention and management of NP and its associated co-morbidities.
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References
I. Johansson MS, Jensen Stochkendahl M, Hartvigsen J, Boyle E, Cassidy JD.Incidence and prognosis of mid-back pain in the general population: A systematic review. Eur J Pain. 2017;21(1):20-28.
Doi: 10.1002/ejp.884.
II. Hoy DG, Protani M, De R, Buchbinder R. The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010;24(6):783-92.
Doi: 10.1016/j.berh.2011.01.019.
III. Rottermund J, Knapik A, Saulicz E, My-liwiec A, Saulicz M, Rygiel KA, et al. Back and neck pain among school teachers in Poland and its correlations with physical activity. Med Pr. 2015;66(6):771-78. Doi:10.13075/mp.5893.00121.
IV. Schaller A, Froboese I. Movement coaching: Study protocol of a randomized controlled trial evaluating effects on physical activity and participation in low back pain patients. BMC Musculoskelet Disord. 2014;15(1):391. Doi: 10.1186/1471- 2474-15- 391.
V. Fishbain DA, Cutler RB, Cole B, Lewis J, Smets E, Rosomoff HL, Rosomoff RS. Are patients with chronic low back pain or chronic neck pain fatigued? Pain Med. 2004;5(2):187-95.
Doi: 10.1111/j.1526-4637.2004.04026. x.
VI. Ruffin 4th MT, Cohen M. Evaluation and management of fatigue. Am Fam Physician. 1994;50(3):625-34.
VII. Wolfe F, Hawley DJ, Wilson K. The prevalence and meaning of fatigue in rheumatic disease. J Rheumatol.
;23(8):1407-17.
VIII. Oliveira JR, Viganó MG, Lunardelli MC, Canêo LC, Goulart Júnior E. Fadiga no trabalho: Como o psicólogo pode atuar? Psicolo Estud. 2010;15(3):633-38.
https://doi.org/10.1590/S1413-73722010000300021.
IX. Fishbain DA, Hall JA, Risser RC, Gonzales JS. Does pain cause the perception of fatigue in patients with chronic pain? Findings from studies for management of diabetic peripheral neuropathic pain with duloxetine.Pain Pract. 2009;9(5):354- 62.
https://doi.org/10.1111/j.1533-2500.2009.00294.x.
X. Fishbain DA, Cole B, Cutler RB, Lewis J, Rosomoff HL, Fosomoff RS. Is pain fatiguing? A structured evidence-based review. Pain Med. 2003;4(1):51-62. Doi: 10.1046/j.1526-4637.2003.03008. x.
XI. Salvetti MD, Pimenta CA, Braga PE, McGillion M. Prevalence of fatigue and associated factors in chronic low back pain patients. Rev Lat Am Enfermagem. 2013;21(SPE):12-19.
https://doi.org/10.1590/S0104-11692013000700003.
XII. Snekkevik H, Eriksen HR, Tangen T, Chalder T, Reme SE. Fatigue and depression in sick-listed chronic low back pain patients. Pain Med. 2014;15(7):1163-70. https://doi.org/10.1111/pme.12435.
XIII. Nicassio PM, Moxham EG, Schuman CE, Gevirtz RN. The contribution of pain reported sleep quality, and depressive symptoms to fatigue in fibromyalgia. Pain. 2002;100(3):271-79. Doi: 10.1016/S0304-3959(02)00300-7.
XIV. Boissonnault W, Di Fabio RP. Pain profiles of patients with low back pain referred to physical therapy. J Orthop Sports Phys Ther. 1996;24(4):180-91.
https://www. jospt.org/doi/10.2519/jospt.1996.24.4.180.
XV. Merskey HE. Classification of chronic pain: Descriptions of chronic pain syndromés and definitions of pain terms. Pain. 1986.
XVI. Smets EM, Garssen B, Bonke BD, De Haes JC. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995;39(3):315-25. https://doi.org/10.1016/0022-3999(94)00 125-O.
XVII. Reeves WC, Wagner D, Nisenbaum R, Jones JF, Gurbaxani B, Solomon L, et al. chronic fatigue syndrome–A clinically empirical approach to its definition and study. BMC Medicine. 2005;3(19):01-09. https://doi.org/10.1186/1741-7015-3-19.
XVIII. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.
https://doi.org/10. 1111/j.1600-0447. 1983.tb09716.x.
XIX. Stern AF. The hospital anxiety and depression scale. Occup Med. 2014;64(5):393-94.
XX. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: An updated literature review. Psychosom Res. 2002;52(2):69-77.
https://doi.org/10.1016/S0022-3999(01)002963.
XXI. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
https://doi.org/10.1016/0165-1781(89)900474.
XXII. Jensen MP, Karoly P. Self-report scales and procedures for assessing pain in adults, In Turk DC & Melzack R (Eds.). Handbook of Pain Assessment. New York: Guilford Press. 2001.
XXIII. Milton K, Bull FC, Bauman A. Reliability and validity testing of a single-item physical activity measure. British J Sports Med. 2011;45(3):203-08.
http:// dx.doi.org/10.1136/bjsm.2009.068395.
XXIV. Centers for Disease Control and Prevention. US Department of Health and Human Services Physical activity guidelines for Americans. Atlanta, GA: Centers for Disease Control and Prevention (CDC). National Center for Chronic Disease Prevention and Health Promotion. 2008:6-17.
XXV. Kim CH, Shin HC, Won CW. Prevalence of chronic fatigue and chronic fatigue syndrome in Korea: Community-based primary care study. J Korean Med Sci. 2005;20(4):529-34.
http://dx.doi.org/10.3346/jkms.2005.20.4.529.
XXVI. Van Dartel SSA, Repping-Wuts, Van Hoogmoed D, Bleijenberg G, Van Riel PL, Fransen J. Association between fatigue and pain in rheumatoid arthritis: Does pain precede fatigue or does fatigue precede pain? Arthritis Care Res (Hoboken). 2013;65(6):862-69.
XXVII. Saravanan A, Tell D, Mathews H, Bajaj P, Janusek LW. Pain, sleep disturbances, fatigue, mood changes, and underlying inflammation: A study of patients with Chronic Low Back Pain (CLBP). J Pain. 2019;20(4):S06-07.
https://doi. org/10.1016/j.jpain.2019.01.040.
XXVIII. Chaudhuri A, Behan PO. Fatigue in neurological disorders. Lancet. 2004;363(9413):978-88.
https://doi.org/10.1016/S0140-6736(04)15794-2.
XXIX. Ciubotariu A, Arendt-Nielsen L, Graven-Nielsen T. Localized muscle pain causes prolonged recovery after fatiguing isometric contractions. Exp Brain Res. 2007;181(1):147-58.
https://doi.org/10.1007/s00221-007-0913-4.
XXX. Fifield J, Tennen H, Reisine S, McQuillan J. Depression and the long-term risk of pain, fatigue, and disability in patients with rheumatoid arthritis. A & R: Official Journal of the American College of Rheumatology. 1998;41(10):1851-57.
Doi: 10.1002/1529-0131(199810)41:10<1851 AID-ART18> 3.0.CO;2-I.
XXXI. Druce KL, Jones GT, Macfarlane GJ, Verstappen SM, Basu N. The longitudinal course of fatigue in rheumatoid arthritis: Results from the Norfolk Arthritis Register. J Rheumatol. 2015;42(11):2059-65. Doi: 10.3899/jrheum.141498.
XXXII. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). Am Psychiatr Publ; 2013 May 22.
XXXIII. Evers AW, Verhoeven EW, van Middendorp H, Sweep FC, Kraaimaat FW, Donders AR, et al. Does stress affect the joints? Daily stressors, stress vulnerability, immune and HPA axis activity, and short-term disease and symptom fluctuations in rheumatoid arthritis. Ann Rheum Dis. 2014;73(9):1683-88. Doi: 10.1136/ annrheumdis-2012-203143.
XXXIV. Van Dartel S, Repping H, Van Hoogmoed D, Knoop H, Bleijenberg G, van Riel P, et al. Longitudinal measurement of fatigue in rheumatoid arthritis: Which factors predict fatigue? Ann Rheum Dis. 2013;72(Suppl 3):A365.
XXXV. Irwin MR, Olmstead R, Carrillo C, Sadeghi N, FitzGerald JD, Ranganath VK, et al. Sleep loss exacerbates fatigue, depression, and pain in rheumatoid arthritis. Sleep. 2012 1;35(4):537-43. Doi: 10.5665/sleep.1742.
XXXVI. Lautenbacher S, Kundermann B, Krieg JC. Sleep deprivation and pain perception. Sleep Med Rev. 2006;10(5):357-69.
Doi: 10.1016/j.smrv.2005.08.001.
XXXVII. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: An update and a path forward. J Pain. 2013;14(12):1539-52.
Doi: 10.1016/j.jpain.2013.08.007.
XXXVIII. Moxham EG. The Contribution of Pain, Nonrestorative Sleep, Depression, and Stress to Fatigue in Fibromyalgia Patients (Doctoral dissertation, California School of Professional Psychology, San Diego).
XXXIX. Karaman S, Karaman T, Dogru S, Onder Y, Citil R, Bulut YE, et al. Prevalence of sleep disturbance in chronic pain. Eur Rev Med Pharmacol Sci. 2014;18(17):2475-81.
XL. Wang HY, Fu TS, Hsu SC, Hung CI. Association of depression with sleep quality might be greater than that of pain intensity among outpatients with chronic low back pain. Neuropsychiatr Dise Treat. 2016;12:1993. https://doi.org/10.2147/NDT.S110162.
XLI. Dworkin RH. Which individuals with acute pain are most likely to develop a chronic pain syndrome? Pain Forum. 1997;6(2):127-36. Churchill Livingstone.