University of Oulu

Miettinen, Teemu; Sverloff, Jaana; Lappalainen, Olli-Pekka; Linton, Steven J.; Sipilä, Kirsi; Kalso, Eija, Sleep problems in pain patients entering tertiary pain care, PAIN: September 23, 2021, doi: 10.1097/j.pain.0000000000002497

Sleep problems in pain patients entering tertiary pain care : the role of pain-related anxiety, medication use, self-reported diseases, and sleep disorder

Saved in:
Author: Miettinen, Teemu1; Sverloff, Jaana2; Lappalainen, Olli-Pekka3;
Organizations: 1Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
2Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
3Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
4Department of Law, Psychology and Social Work, Centre for Health and Medical Psychology, Örebro University, Örebro, Sweden
5Oral and Maxillofacial Department, Medical Research Centre Oulu, Oulu University Hospital, Oulu, Finland
6Department of Pharmacology and SleepWell Research Programme, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: Wolters Kluwer, 2021
Publish Date: 2021-11-16


Chronic pain and sleep problems frequently co-occur. Pain itself disturbs sleep, but other factors may also contribute to sleep problems in pain patients. This cross-sectional study of 473 patients (69.9% female, mean age 47 years) entering tertiary pain management compared normally sleeping pain patients with those having recurring sleep problems to determine the relationship between pain and sleep. Groups were compared for pain and pain aetiology, pain-related anxiety, childhood adversities, use of sleep and pain medications, self-reported diseases, and sleep disorders. Furthermore, the association of pain-related anxiety (cognitive anxiety, escape/avoidance, fear, and physiological anxiety) with more disturbing sleep problems was investigated in the whole cohort. The main results were that those with sleep problems more often reported multiple health conditions than those sleeping normally (depression 31.6% vs 5.0%; angina pectoris 6.5% vs 0.0%; asthma 19.6% vs 1.7%; low back problems 55.1% vs 23.3%; joint disease other than rheumatoid arthritis 32.3% vs 18.3%). Accumulations of 5 or more childhood adversities were more often present in those with sleep problems. Restless legs symptoms were more common in those with sleep problems than those sleeping normally (33.2% vs 11.7%). Patients having sleep problems reported more use of sleep and pain medications than those sleeping normally. Findings about pain-related anxiety suggest physiological reactions as significant factors for increased sleep disturbances. These factors need to be addressed in the management of the comorbidity of pain and sleep problems, and research to understand mechanisms in these is sorely needed.

see all

Series: Pain
ISSN: 0304-3959
ISSN-E: 1872-6623
ISSN-L: 0304-3959
Volume: In press
DOI: 10.1097/j.pain.0000000000002497
Type of Publication: A1 Journal article – refereed
Field of Science: 3111 Biomedicine
Funding: Government funding for university level health research (TYH2014214), Signe and Ane Gyllenbergs Foundation, and a grant from the Finnish Association for the Study of Pain.
Copyright information: © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.