SLEEP-EVAL© RESEARCH

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Stanford Sleep Epidemiology Journal

Stanford Sleep Epidemiology Research Center (SSERC)

Psy-EVAL Research

 

"Not everything that can be counted counts,
and not everything that counts can be counted."
 Albert Einstein

 

Chronic Pain

First created | 02/03/2000

Last edited   |

Summary by Maurice M. Ohayon, MD, DSc, PhD

Reference to cite:

 

The sample included 18,980 subjects between 15 and 100 years old. Subjects from the United Kingdom represented 26.2% of the sample; German subjects 21.7%; Spanish subjects 21.4%; Italian subjects 20.9%; and Portuguese subjects 9.8%.

Prevalence of chronic painful physical conditions

At the time of the interview, 17.1% (95% CI: 16.5% to 17.6%) of the subjects reported at least one chronic painful physical condition.
Women more frequently than men reported having a chronic painful physical condition (20.7% vs. 13.2%; p<.0001).
The prevalence linearly increased with age: 11.4% in subjects younger than 25 years old and 25.4% in those 65 years of age or older (p<.0001).

Headaches were reported by 7.6% of the sample, followed by pain in lower or upper limbs (5.8%), joint/articular disease (3.2%), backaches (3.1%) and gastro-intestinal diseases (1.5%).
Prevalence of pain in lower or upper limbs and gastro-intestinal diseases were comparable between men and women.
The other chronic painful physical conditions were more frequent in women than in men (Table 1).
All these conditions significantly increased with age.

More Information

Medical & Psychiatric Correlates
Smoking is positively related to difficulties in initiating sleep and estimated sleep latency.

Although often reported in clinical studies, the association between the use of antihypertensive drugs and insomnia was seldom reported in epidemiological studies.
On sleep patterns, alcohol at bedtime accelerates the sleep onset, increases the amount of slow-wave sleep, decreases the amount of REM sleep and causes sleep disruption in the second half of the sleep period.
About four out of 10 insomnia subjects medicate themselves with over-the-counter medications or alcohol.
Other medications, such as serotonergic reuptake inhibitors (SSRIs), some neuroleptics, some antiparkinsonians and amphetamines may all provoke insomnia among patients using these kinds of medications. Hypnotics and anxiolytics may cause insomnia

 

Morning Headaches

Waking up with a headache is traditionally associated with sleep disorders

 

Hypertension

Obstructive Sleep Apnea Syndrome is an independent risk factor (odds ratio: 9.7) for hypertension. Snoring and breathing pauses during sleep appeared to be non-significant predictive factors.

 

Chronic Pain

 

Depression, Pain and Sleep
Surprisingly, few studies have attempted to determine if a comorbid medical condition in individuals with chronic painful physical disease increased the likelihood of having a major depressive disorder

 

Depression with Psychotic Features

There are little data regarding the prevalence of associated psychotic features in subjects with major depressive disorders in the general population

Sleep Apnea and Depression
 Some clinical studies have attempted to determine whether depression limits the recognition and treatment of breathing-related sleep disorders, or if breathing-related sleep disorders play a role in the etiology or course of depressive disorder