1
|
Haidary M, Arif S, Hossaini D, Madadi S, Akbari E, Rezayee H. Pain-Insomnia-Depression Syndrome: Triangular Relationships, Pathobiological Correlations, Current Treatment Modalities, and Future Direction. Pain Ther 2024; 13:733-744. [PMID: 38814408 PMCID: PMC11255165 DOI: 10.1007/s40122-024-00614-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024] Open
Abstract
Pain-insomnia-depression syndrome (PIDS) is a complex triad of chronic pain, insomnia, and depression that has profound effects on an individual's quality of life and mental health. The pathobiological context of PIDS involves complex neurobiological and physiological mechanisms, including alterations in neurotransmitter systems and impaired pain processing pathways. The first-line therapeutic approaches for the treatment of chronic pain, depression, and insomnia are a combination of pharmacological and non-pharmacological therapies. In cases where patients do not respond adequately to these treatments, additional interventions such as deep brain stimulation (DBS) may be required. Despite advances in understanding and treatment, there are still gaps in knowledge that need to be addressed. To improve our understanding, future research should focus on conducting longitudinal studies to uncover temporal associations, identify biomarkers and genetic markers associated with PIDS, examine the influence of psychosocial factors on treatment responses, and develop innovative interventions that address the complex nature of PIDS. The aim of this study is to provide a comprehensive overview of these components and to discuss their underlying pathobiological relationships.
Collapse
Affiliation(s)
- Murtaza Haidary
- Medical Research and Technology Center, Khatam Al-Nabieen University, Kabul, Afghanistan.
| | - Shamim Arif
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | - Dawood Hossaini
- Department of Biology and Microbiology, Faculty of Medical Laboratory Technology, Khatam Al-Nabieen University, Kabul, Afghanistan
| | - Shekiba Madadi
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | - Elham Akbari
- Department of Biology and Microbiology, Faculty of Medical Laboratory Technology, Khatam Al-Nabieen University, Kabul, Afghanistan
| | - Hossain Rezayee
- Department of Chemistry and Biochemistry, Faculty of Medical Laboratory Technology, Khatam Al-Nabieen University, Kabul, Afghanistan
| |
Collapse
|
2
|
He Y, Wang J, Zhao P, Wang R, Li M. Correlations of The Central Sensitization Inventory, conditioned pain modulation, cognitions and psychological factors in individuals with chronic neck pain: A cross-sectional study. Pain Ther 2024; 13:843-856. [PMID: 38789828 PMCID: PMC11254877 DOI: 10.1007/s40122-024-00601-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/02/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Chronic neck pain (CNP) is a global public health problem, with high prevalence and absenteeism rates. Central sensitization (CS) as a basis for chronic pain may play an essential role in its development and progression. It is often comorbid with low conditioned pain modulation (CPM) effects, cognitions, and psychological problems. OBJECTIVES The purposes of this study were to (1) explore the relationship between pain-related cognitions and psychological factors, CPM effects, and the central sensitization inventory (CSI) scores; and (2) determine whether cognitions and psychological factors can predict CSI scores and CPM effects in individuals with CNP. METHODS Fifty-four individuals with CNP were recruited for this cross-sectional study. The following outcome measures were evaluated: The CSI (screening tool) was compared with the cold pressor test (CPT), which was the psychophysical test used to assess the CPM; neck pain intensity using the visual analogue scale (VAS), as well as pain-related cognitions (including kinesiophobia and pain catastrophization) and psychological states (including anxiety and depression) using self-report questionnaires. RESULTS CSI score was not associated with the CPM effect (r = 0.257, p > 0.05), and no cognitions or psychological factors were associated with CPM (p > 0.05), but CSI score was moderately positively correlated with kinesiophobia (r = 0.554, p < 0.01), lowly positively correlated with pain catastrophization (r = 0.332, p = 0.017) and anxiety (r = 0.492, p < 0.01), but not depression (r = 0.207, p = 0.132). Multiple linear regression analysis showed that kinesiophobia (B = 1.308, p < 0.01) and anxiety (B = 1.806, p = 0.02) were significant positive predictors of CSI score. CONCLUSIONS The findings confirm some of our hypotheses. Accordingly, the findings inferred that the CSI does not seem to respond to CPM effect in patients with CNP effectively. In addition, CSI score was associated with cognitions and psychological factors, of which kinesiophobia and anxiety were effective predictors. In clinical practice, pain-related cognitions and psychological factors should be fully considered to manage neck pain efficiently.
Collapse
Affiliation(s)
- Yuwei He
- College of Sports Medicine and Rehabilitation, Beijing Sport University, 48 Information Road, Haidian District, Beijing, 100084, China
| | - Jialin Wang
- China Institute of Sports Science, General Administration of Sport, 11 Gymnasium Road, Dongcheng District, Beijing, 100061, China
| | - Peng Zhao
- China Institute of Sports Science, General Administration of Sport, 11 Gymnasium Road, Dongcheng District, Beijing, 100061, China.
| | - Ruirui Wang
- College of Sports Medicine and Rehabilitation, Beijing Sport University, 48 Information Road, Haidian District, Beijing, 100084, China
| | - Meng Li
- College of Sports Medicine and Rehabilitation, Beijing Sport University, 48 Information Road, Haidian District, Beijing, 100084, China
| |
Collapse
|
3
|
Chen J, Fang X, Zhang F, Shen J, Liu Y, Xu P, Ye R, Zhong Q, Chen G, Wang Z, Chen S, Li L, Lin Z, Gao Y. The associations of chronic pain and 24-h movement behaviors with incident mental disorders: evidence from a large-scale cohort study. BMC Med 2024; 22:313. [PMID: 39075461 PMCID: PMC11287891 DOI: 10.1186/s12916-024-03534-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 07/17/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Chronic pain was associated with a higher risk of mental disorders (e.g., depression and anxiety). However, the role of 24-h movement behaviors in the association remains unclear. METHODS A total of 72,800 participants with accelerometer data and free of mental disorders from the UK Biobank were analyzed. The compositional mediation model and isotemporal substitution model were used to explore the associations between chronic pain, 24-h movement behaviors, and the incidence of overall mental disorders, depression, and anxiety. RESULTS With a median follow-up of 13.36 years, participants with chronic pain had a higher rate of incident overall mental disorders (hazard ratio (HR): 1.281, 95% confidence interval (CI): 1.219 to 1.344), anxiety (HR: 1.391, 95% CI: 1.280 to 1.536), and depression (HR: 1.703, 95% CI: 1.551 to 1.871). Increased sedentary behavior (SB) and reduced moderate-to-vigorous physical activity (MVPA) caused by chronic pain both increased the risk of mental disorders. Twenty-four-hour movement behaviors explained the relationship between chronic pain and overall mental disorders, depression, and anxiety by 10.77%, 5.70%, and 6.86%, respectively. Interaction effects were found between MVPA and chronic pain when predicting the incidence of depression and between MVPA, sleep (SLP), and chronic pain when predicting the incidence of mental disorders. People with chronic pain would recommend at least 0.5 h per day of MVPA and 7 h per day of SLP and restricting SB below 11.5 h per day. CONCLUSIONS Twenty-four-hour movement behaviors played a significant mediating role in the association between chronic pain and mental disorders. Individuals with chronic pain should engage in more MVPA, less sedentary behavior, and have 7-h sleep per day.
Collapse
Affiliation(s)
- Jiade Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Xuanbi Fang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Fan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Jiaxin Shen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Yuanhang Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Peng Xu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
- The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China
| | - Rongrong Ye
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Qingguang Zhong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Guanren Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Zhehao Wang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Shentong Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Lixia Li
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
| | - Yanhui Gao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
- Key Laboratory of Viral Pathogenesis & Infection Prevention and Control (Jinan University), Ministry of Education, Guangzhou, China.
| |
Collapse
|
4
|
Liu C, Ye Z, Chen L, Wang H, Wu B, Li D, Pan S, Qiu W, Ye H. Interaction effects between sleep-related disorders and depression on hypertension among adults: a cross-sectional study. BMC Psychiatry 2024; 24:482. [PMID: 38956492 PMCID: PMC11221077 DOI: 10.1186/s12888-024-05931-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Hypertension, sleep disorders, and depression represent notable public health issues, and their interconnected nature has long been acknowledged. The objective of this study is to explore the interplay between sleep disorders and depression in the context of hypertension. METHODS This cross-sectional study involved 42,143 participants aged 18 and above from the NHANES database across seven survey cycles between 2005 and 2018. After excluding those with missing data on depression, sleep disorders, and hypertension, as well as incomplete main variables, 33,383 participants remained. We used weighted logistic regression to examine the relationship between sleep disorders, depression, and hypertension. Additionally, we assessed the interaction between sleep disorders and depression on hypertension using both multiplicative and additive approaches to quantify their combined effect. RESULTS Compared to individuals without sleep disorders, those with sleep disorders have an increased risk of hypertension (OR = 1.51, 95% CI: 1.37-1.67). Furthermore, individuals with depression experience a significantly higher risk of hypertension compared to those with sleep disorders alone (OR = 2.34, 95% CI: 1.95-2.80). Our study reveals a positive interaction between sleep disorders and depression in relation to hypertension risk (OR = 1.07, 95% CI: 1.02-1.13). In addition, we observed the quantitative additive interaction indicators (RERI = 0.73, 95% CI: 0.56 ~ 0.92; API = 0.31, 95% CI: 0.11 ~ 0.46; SI = 2.19, 95% CI: 1.08-3.46) influencing hypertension risk. Furthermore, our research also identified that individuals with less than 7 h of sleep, a sleep latency period between 5 and 30 min, or a latency period exceeding 30 min experience a significantly increased risk of hypertension. CONCLUSIONS Our research uncovered separate links between sleep disorders, depression, and hypertension prevalence. Moreover, we identified an interaction between depression and sleep disorders in hypertension prevalence. Enhancing mental well-being and tackling sleep disorders could help prevent and manage hypertension. Yet, more investigation is required to establish causation and clarify mechanisms.
Collapse
Affiliation(s)
- Chunhua Liu
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Zegen Ye
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Liping Chen
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Huaqiang Wang
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Binbin Wu
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Di Li
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Sisi Pan
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China
| | - Weiwen Qiu
- Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui City, Zhejiang Province, China.
- Department of Neurology, Lishui Hospital of Traditional Chinese Medicine, Zhejiang University of Chinese Medicine, 800 Zhongshan Street, Lishui City, Zhejiang, 323000, China.
| | - Haiqin Ye
- Lishui Central Hospital, No. 289 Kuocang Road, Liandu District, Lishui City, Zhejiang Province, China.
- Department of Clinical Training, Lishui Municipal Central Hospital, Lishui, Zhejiang Province, 323000, China.
| |
Collapse
|
5
|
Zhu Y, Bi Y, Zhu T. Mendelian randomization highlights sleep disturbances mediated the effect of depression on chronic pain. Brain Behav 2024; 14:e3596. [PMID: 38967065 PMCID: PMC11224770 DOI: 10.1002/brb3.3596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/20/2024] [Accepted: 05/26/2024] [Indexed: 07/06/2024] Open
Abstract
INTRODUCTION Depression and chronic pain are significant contributors to the global burden of disease. Previous research has revealed complex relationships between these two conditions, which may be influenced by sleep quality. However, observational studies have limitations, including confounding factors and reverse causation. This study aims to explore the mediating effects of sleep on the relationship between depression and chronic pain using Mendelian randomization (MR). METHODS We conducted a two-step, two-sample MR study using mediation analysis. We obtained major depressive disorder (MDD) Genome-Wide Association Studdies (GWAS) data from Wray et al.'s GWAS meta-analysis. Phenotypic data related to sleep were collected from the UK Biobank. Chronic pain data were obtained from the Finnish database. RESULTS MR analysis revealed significant genetic associations between MDD and chronic localized pain [IVW: odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.16-1.38, p = 2.52 × 10-7] as well as fibromyalgia (IVW: OR = 2.17, 95% CI = 1.34-3.52, p = .002). Genetic susceptibility for MDD was also associated with insomnia (IVW: OR = 1.10, 95% CI = 1.06-1.13, p = 3.57 × 10-8) and self-reported short sleep duration (IVW: OR = 1.03, 95% CI = 1.00-1.06, p = .047). The mediating effects of insomnia and fibromyalgia on the pathway from depression to chronic regional pain were 1.04 and 1.03, respectively, with mediation proportions of 12.8% and 15.2%. Insomnia mediated the pathway between depression and fibromyalgia with an effect of 1.12, accounting for 15.2% of the total effect. CONCLUSION This two-step MR analysis strengthens the evidence of genetic predictive associations between depression and chronic pain, highlighting the mediating roles of insomnia and short sleep duration. It further elucidates the specific roles of distinct sleep disorders, differentiating insomnia and short sleep duration from other sleep-related phenotypes.
Collapse
Affiliation(s)
- Yingchao Zhu
- Department of Anesthesiology, West China HospitalSichuan UniversityChengduSichuanChina
| | - Yaodan Bi
- Department of Anesthesiology, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijingChina
| | - Tao Zhu
- Department of Anesthesiology, West China HospitalSichuan UniversityChengduSichuanChina
| |
Collapse
|
6
|
Wang T, Wang Q, Li X, Wang C, Wang R, Wang C, Ding H, Qian L, Wan X, Tian X, Hou Z, Liu F, Liu J, Cheng X, Zhang J. A control study on pain characteristics and influencing factors in patients with depressive disorders-based on a 5-year follow-up report from the epidemiological survey of mental disorders in Shandong Province, China. J Affect Disord 2024; 355:290-298. [PMID: 38556095 DOI: 10.1016/j.jad.2024.03.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/26/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND This study extends from the 2015 Shandong Province Epidemiological Survey of Mental Disorders in adults aged 18 and above. Over five years, it investigates pain characteristics and influencing factors in individuals with depressive disorders in Shandong Province. METHODS The study encompasses 871 individuals who met DSM-IV criteria for depressive disorders in 2015. Using 1:1:1 matching by gender, age, and residence, 825 non-afflicted individuals were selected as high-risk controls, and 825 screening-negative individuals became low-risk controls. A follow-up study in 2020 involved 1848 participants. Survey tools included a general information questionnaire, General Health Questionnaire-12 (GHQ-12), SCID-I/P, Global Pain Scale (GPS), Quality of Life Questionnaire (QLQ), PSQI, MoCA, and clinical data questionnaire. RESULTS GPS scores in the current depressive group were higher than in non-current depressive group (Z = 14.36, P < 0.01). GPS scores in study group exceeded those in high-risk and low-risk control groups (H = 93.71, P < 0.01). GPS scores in non-remission group were higher than in the remission group (Z = 8.90, P < 0.01). Regression analysis revealed positive correlations between GPS scores and physical illnesses, current depression, incumbency, GHQ-12 total score, and PSQI total score. Negative correlations were observed with QLQ total score and MoCA total score. LIMITATIONS The study could not assess pain during the 2015 survey, limiting controlled pain analysis before and after five years. CONCLUSION Depression sufferers may experience prolonged heightened pain, potentially relieved when depression subsides. Individual pain is influenced by depression, physical illnesses, sleep quality, quality of life, cognitive function, gender, residence, and occupation.
Collapse
Affiliation(s)
- Tao Wang
- Department of Psychiatry, School of Mental Health, Jining Medical University, China
| | - Qian Wang
- Shandong Province Hospital of Occupational Diseases, China
| | | | - Can Wang
- Shandong Mental Health Center, China
| | | | | | - Hao Ding
- Zibo Mental Health Center, China
| | - Liju Qian
- Daizhuang Hospital, Shandong Province, China
| | | | - Xue Tian
- Linyi Mental Health Center, China
| | | | - Fengjie Liu
- The Fourth People's Hospital of Liaocheng, China
| | | | - Xiaojing Cheng
- Shandong Academy of Occupational Health and Occupational Medicine, China.
| | | |
Collapse
|
7
|
Sandri E, Piredda M, De Maria M, Mancin S, Sguanci M, Cabo A, Cerdá Olmedo G. Development and psychometric testing of the nutritional and social health habits scale (NutSo-HH): A methodological review of existing tools. MethodsX 2024; 12:102768. [PMID: 38883583 PMCID: PMC11177200 DOI: 10.1016/j.mex.2024.102768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
Habits represent repeated patterns of behavior over time that exert a significant influence on individual health. While specific tools exist to measure individual habits, the number of instruments capable of simultaneously exploring multiple dimensions of health is limited. This research had two main objectives: 1) to examine the literature to find existing tools for evaluating health habits, especially in the Spanish population; 2) through a methodological review, to develop and validate a tool capable of measuring multiple dimensions of health habits. The Nutritional and Social Health Habits Scale (NutSo-HH) was conceived, tested, and refined through pilot testing with cognitive interviews and expert content validation. Construct validity was explored through confirmatory factor analysis and known-group validity, while criterion validity was verified in comparison with the ``Healthy Nutrition Index for the Spanish Population.'' Reliability was assessed using omega coefficients. Confirmatory factor analysis yielded satisfactory fit indices. The final model included two second-order factors (nutritional habits and health habits) and two first-order factors (Mediterranean diet and alcohol consumption). Omega coefficients ranged from 0.521 to 0.815. The NutSo-HH Scale emerges as a valid and reliable tool to assess nutritional and social habits among Spanish young adults. This novel instrument fills a gap in the field, allowing exploration of various health determinants through a single scale and providing support for decision-making in the realm of public health nutrition.
Collapse
Affiliation(s)
- Elena Sandri
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, c/Quevedo, 2, Valencia 46001, Spain
- Doctoral School, Catholic University of Valencia San Vicente Mártir, c/Quevedo, 2, Valencia 46001, Spain
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Maddalena De Maria
- Department of Life Health Sciences and Health Professions, Link Campus University, Via del Casale di San Pio V, 44, 00165 Rome, Italy
| | - Stefano Mancin
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy
| | - Marco Sguanci
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Asensi Cabo
- Clinical Psychologist, Onda Town Council, Career Civil Servant, c/El Pla 1, Onda-Castellón, 12200, Spain
| | - Germán Cerdá Olmedo
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, c/Quevedo, 2, Valencia 46001, Spain
| |
Collapse
|
8
|
Onyeakazi UM, Columb MO, Rosalind A, Kanakarajan S, Galley HF. Melatonin treatment has consistent but transient beneficial effects on sleep measures and pain in patients with severe chronic pain: the DREAM-CP randomised controlled trial. Br J Anaesth 2024; 132:725-734. [PMID: 38355388 PMCID: PMC10925889 DOI: 10.1016/j.bja.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Sleep disturbance is a major issue for patients with chronic pain. Melatonin has been shown to improve symptoms of fibromyalgia, but its efficacy in other chronic non-malignant pain conditions is not fully known. Hence, we determined the effect of melatonin in patients with severe noncancer chronic pain. METHODS This was a randomised double-blinded crossover trial of modified-release melatonin as Circadin™ compared with placebo. Sixty male and female subjects with chronic severe pain were randomised to receive either 2 mg of Circadin™ or placebo before sleep for 6 weeks, followed by a >4 week washout, then crossing over to the other treatment. Sleep disturbance, quality, and latency were measured using three different validated sleep assessment tools. The primary outcome measure was self-reported sleep disturbance after 6 weeks of treatment. Adverse events were also recorded. RESULTS Sleep disturbance after 6 weeks was not significantly altered by melatonin treatment, but differences between melatonin and placebo treatment periods after 3 weeks were seen: sleep disturbance (P=0.014), latency (P=0.04), overall sleep quality (P=0.004), and effect of pain on sleep (P=0.032). Pain intensity scores improved during both treatment periods (both P<0.001). There were no differences in adverse events between treatment periods. CONCLUSIONS Circadin™ treatment did not improve sleep disturbance in patients with severe chronic pain compared with placebo at 6 weeks, but there were consistent improvements in aspects of sleep in the shorter term. Given its favourable safety profile, it could be beneficial for some patients with chronic pain. CLINICAL TRIAL REGISTRATION ISRCTN12861060.
Collapse
Affiliation(s)
- Uzunma M Onyeakazi
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Malachy O Columb
- Manchester University Hospitals NHS Foundation Trust, Wythenshawe, UK
| | - Adam Rosalind
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | | | - Helen F Galley
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
| |
Collapse
|
9
|
Bi Y, Zhu Y, Tang S. Therapeutic Potential of Downregulated Interleukin-6 Signaling for the Treatment of Chronic Pain: A Mendelian Randomization Study. J Pain Res 2023; 16:4317-4328. [PMID: 38145035 PMCID: PMC10743722 DOI: 10.2147/jpr.s424086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction While numerous studies have emphasized the pivotal involvement of the Interleukin 6 (IL-6) pathway in the development of chronic pain, the causal nature of this relationship remains uncertain. Methods In this study, we opted to include genetic variants situated within the locus of the IL-6 receptor (IL-6R) that exhibited associations with C-reactive protein (CRP) levels. CRP serves as a downstream effector in the IL-6 pathway. Utilizing these variants as genetic proxies, we aimed to modulate IL-6 signaling. Employing a two-sample Mendelian randomization (MR) approach, we investigated the potential link between the genetic proxy and seven distinct subtypes of chronic pain, categorized based on their corresponding body locations. Moreover, we examined the relationship between chronic pain and an alternative instrument of IL-6 signaling that was weighted based on s-IL-6R levels. Furthermore, we conducted exploratory analyses to estimate the plausible causal association between CRP, gp130, and the subtypes of chronic pain. Results Our analysis showed that genetic proxied downregulation of IL-6 signaling, weighted on CRP levels, was linked to a reduced risk of chronic back and knee pain. The sensitivity analyses across various MR methods confirmed the consistency of the findings and showed no evidence of horizontal pleiotropy or heterogeneity. Moreover, the results remained robust with different sets of instrument variables. A genetically increased level of s-IL-6R was also negatively associated with chronic back and knee pain. However, there was no causal relationship between CRP and gp130 with chronic pain. Conclusion Based on our findings, there is evidence to suggest a potential causal relationship between IL-6 signaling and chronic back and knee pain. Consequently, the downregulation of IL-6 signaling holds promise as a potential therapeutic target for addressing chronic back and knee pain.
Collapse
Affiliation(s)
- Yaodan Bi
- Department of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Yingchao Zhu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Shuai Tang
- Department of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| |
Collapse
|
10
|
Delbari A, Ghavidel F, Bidkhori M, Saatchi M, Abolfathi Momtaz Y, Efati S, Hooshmand E. Evaluation of Sleep Quality and Related Factors in Community-Dwelling Adults: Ardakan Cohort Study on Aging (ACSA). J Res Health Sci 2023; 23:e00591. [PMID: 38315906 PMCID: PMC10660504 DOI: 10.34172/jrhs.2023.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/18/2023] [Accepted: 08/29/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Sleep is a necessary physiological process that affects health. The current study aimed to evaluate sleep quality (SQ) and the related factors in Iranian community-dwelling adults. Study Design: A cross-sectional study. Method: Population-based cross-sectional data from the first wave of the Ardakan cohort study on aging (ACSA) were analyzed. The analytical sample consisted of 5197 community-dwelling adults aged≥50. All data were collected by trained staff. Pittsburgh Sleep Quality Index (PSQI) scores were used to measure SQ. Univariable and multivariable logistic regression were used to identify predictors of SQ. RESULTS The mean age of the participants was 62.22±7.7 years, and 51.8% were female. About threequarters of them (76.36%) were found to have poor SQ (PSQI score≥5). Multivariable logistic regression analysis revealed a relationship between SQ and gender, education, work, and financial level. Furthermore, SQ was found to be associated with self-reported health and physical activity. Regarding comorbidity, SQ had a significant relationship with cardiovascular diseases, musculoskeletal diseases, depression, and anxiety (P<0.05). CONCLUSION The prevalence of poor SQ was high in these community-dwelling adults in Iran. These findings highlight the importance of intervention programs for sleep hygiene education and screening for middle-aged and older adults.
Collapse
Affiliation(s)
- Ahmad Delbari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Ghavidel
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Bidkhori
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Department of Biostatistics and Epidemiology, School of Rehabilitation, University of Social Welfare and Rehabilitation Science, Tehran, Iran
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Yadollah Abolfathi Momtaz
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Sara Efati
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Elham Hooshmand
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|