Sleep problems and fatigue as a predictor for the onset of chronic widespread painover a 5- and 18-year perspective: a 20-year prospective study

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Aili, KatarinaKarolinska Institutet,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden & FoU Spenshult, Halmstad, Sweden (författare)

Sleep problems and fatigue as a predictor for the onset of chronic widespread painover a 5- and 18-year perspective : a 20-year prospective study

Artikel/kapitelEngelska2018

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2018-06-12
London :BMJ Publishing Group Ltd,2018
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LIBRIS-ID:oai:DiVA.org:hh-37138
https://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-37138URI
https://doi.org/10.1136/annrheumdis-2018-eular.3285DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:139254602URI
https://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-38333URI

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Språk:engelska
Sammanfattning på:engelska

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Background: If localised pain represent one end of a pain spectra, with overall better general health, chronic widespread pain (CWP) and fibromyalgia represent the other end of the spectra with worse general health and more comorbidities with other somatic diseases and mental illness. Sleep problems and fatigue are common among individuals reporting CWP and previous research indicate that sleep problems may be an important predictor for pain prognosis.Objectives: The aim of this population-based study was to investigate if sleep problems and fatigue predict the onset of CWP 5 and 18 years later.Methods: In order to get more stable baseline classifications of CWP, a wash-out period was used, including only individuals who had not reported CWP (according to ACR 1990 criteria for fibromyalgia) at baseline (−98) and three years prior baseline (−95). In all, data from 1249 individuals entered the analyses for the 5 year follow-up (−03) and 791 entered for the 18 year follow-up (−16). Four parameters related to sleep (difficulties initiating sleep, maintaining sleep, early morning awakening and non-restorative sleep), and one parameter related to fatigue (SF-36 vitality scale) were investigated as predictors for CWP. Binary logistic regression analysis were used for analyses.Results: All investigated parameters predicted the onset of CWP five years later (problems with initiating sleep (OR 1.91; 1.16–3.14), maintaining sleep (OR 1.85; 1.14–3.01), early awakening (OR 2.0; 1.37–3.75), non-restorative sleep (OR 2.27; 1.37–3.75) and fatigue (OR 3.70; 1.76–7.84)) in a model adjusted for age, gender, socio-economy and mental health. All parameters except problems with early awakening predicted the onset of CWP also 18 years later. In all, 785 individuals did not report any of the sleeping problems at baseline (fatigue not included), 268 reported one of the problems, 167 two, 128 three and 117 subjects reported to have all four sleep problems. Reporting all four sleep problems was significantly associated with CWP at follow-up at both time points when adjusting for age, gender, socio economy and mental health (OR 4.00; 2.03–7.91 and OR 3.95; 1.90–8.20); adjusting for age, gender, socio economy and number of pain regions (OR 2.94; 1.48–5.82 and OR 2.65; 1.24–5.64) and in a model adjusting for age, gender, socio economy and pain severity (OR 2.97;1.53–5.76; and OR 3.02;1.47–6.21) for the 5 year and 18 year follow-up respectively, compared to not reporting any of the sleep problems at baseline.Conclusions: Both sleeping problems and fatigue predicts the onset of CWP 5- and 18 years later. The results highlight the importance of the assessment of sleep quality in the clinic.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Omvårdnad hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Nursing hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Public Health, Global Health, Social Medicine and Epidemiology hsv//eng
Chronic widespread pain
Sleep problems

Biuppslag (personer, institutioner, konferenser, titlar ...)

Andersson, Maria L.E.1968-FoU Spenshult, Halmstad, Sweden & Department of Clinical Sciences, Lund University, Lund, Sweden(Swepub:hh)marian (författare)
Bremander, Ann,1957-Högskolan i Halmstad,Rydberglaboratoriet för tillämpad naturvetenskap (RLAS),FoU Spenshult, Halmstad, Sweden(Swepub:hh)annbre (författare)
Haglund, Emma,1970-Högskolan i Halmstad,Rydberglaboratoriet för tillämpad naturvetenskap (RLAS),FoU Spenshult, Halmstad, Sweden(Swepub:hh)emmhag (författare)
Larsson, Ingrid,1968-Högskolan i Halmstad,Centrum för forskning om välfärd, hälsa och idrott (CVHI),FoU Spenshult, Halmstad, Sweden,Hälsa och hållbar uppväxt(Swepub:hh)inglar (författare)
Bergman, Stefan,1959-FoU Spenshult, Halmstad, Sweden & Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden(Swepub:hh)steber (författare)
Karolinska InstitutetInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden & FoU Spenshult, Halmstad, Sweden (creator_code:org_t)

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Ingår i:Annals of the Rheumatic DiseasesLondon : BMJ Publishing Group Ltd77, s. 87-870003-49671468-2060

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