Today's article from sciencedaily.com (see link below) looks at the link between restless and disturbed sleep patterns and chronic pain, especially amongst older people. I think almost everybody living with chronic pain can identify with that. A bad night's sleep almost always results in more pain in the morning. Whether it's the pain that causes the poor sleep, or the other way around, is the question. Could Restless Sleep Cause Widespread Pain in Older People?
Date:
February 13, 2014
Source:
Wiley
Summary:
Researchers in the U.K. report that non-restorative sleep is the strongest, independent predictor of widespread pain onset among adults over the age of 50. According to the study anxiety, memory impairment, and poor physical health among older adults may also increase the risk of developing widespread pain. Muscle, bone and nerve (musculoskeletal) pain is more prevalent as people age, with up to 80% of people 65 years of age and older experiencing daily pain. Widespread pain that affects multiple areas of the body —- the hallmark feature of fibromyalgia —- affects 15% of women and 10% of men over age 50 according to previous studies.
Researchers in the U.K. report that non-restorative sleep is the strongest, independent predictor of widespread pain onset among adults over the age of 50. According to the study published in Arthritis & Rheumatology (formerly Arthritis & Rheumatism), a journal of the American College of Rheumatology (ACR), anxiety, memory impairment, and poor physical health among older adults may also increase the risk of developing widespread pain.
Muscle, bone and nerve (musculoskeletal) pain is more prevalent as people age, with up to 80% of people 65 years of age and older experiencing daily pain. Widespread pain that affects multiple areas of the body -- the hallmark feature of fibromyalgia -- affects 15% of women and 10% of men over age 50 according to previous studies.
Led by Dr. John McBeth from the Arthritis Research UK Primary Care Centre, Keele University in Staffordshire, this newly published population-based prospective study identified factors that increase the risk of the development of widespread pain in older adults. The team collected data on pain, psychological and physical health, lifestyle and demographic information from 4326 adults over the age of 50 who were free of widespread pain at the start of the study (1562 subjects reported no pain and 2764 had some pain). These participants were followed up three years later for the development of widespread pain.
Results show that at follow-up, 800 (19%) reported new widespread pain. The development of new widespread pain was greater in those with some pain at the start of the study; 679 (25%) of those with some pain and 121 (8%) of those with no pain at the start developed new widespread pain at three year follow-up.
Analyses determined that pain status, anxiety, physical health-related quality of life, cognitive complaint and non-restorative sleep were associated with increased risk of widespread pain development, after adjusting for osteoarthritis (OA). Increasing age was associated with a decreased likelihood of the development of widespread pain.
"While OA is linked to new onset of widespread pain, our findings also found that poor sleep, cognition, and physical and psychological health may increase pain risk," concludes Dr. McBeth. "Combined interventions that treat both site-specific and widespread pain are needed for older adults."
Story Source:
The above story is based on materials provided by Wiley. Note: Materials may be edited for content and length.
Journal Reference:
John McBeth, Rosie J Lacey, Ross Wilkie. Predictors of new onset widespread pain in older adults Results from the prospective population-based NorStOP study. Arthritis & Rheumatology, 2013; DOI: 10.1002/art.38284
http://www.sciencedaily.com/releases/2014/02/140213083711.htm
Today's post from medicinenet.com (see link below) looks at the serious problem of sleep-deprivation and the effect it can have on your mental health. People living with neuropathy very often have disturbed sleep patterns. For some reason that nobody seems to be sure of, neuropathy symptoms can flare up during the night and pains in legs and feet can seriously affect your quality of life. It's logical really that prolonged lack of quality sleep will leave you drained during the day. Over a period of time that lack of energy and constant tiredness can lead to depression. If this is the case with you and you feel yourself being impacted by this, don't hesitate to contact your doctor and get help and advice but remember, sleeping tablets may not be the answer because the symptoms will continue despite being masked by the drugs. One thing is sure, don't ignore it and hope it will go away; make sure your medical professionals are aware of the problem.
By Tara Haelle HealthDay Reporter WEDNESDAY, Aug. 13, 2014 (HealthDay News)
Sleeping difficulties may increase the risk of suicide in older adults even when other symptoms of depression aren't present, a new study suggests.
The study focused on adults 65 and older, and poor sleep included difficulty falling or staying asleep, waking up early in the morning, experiencing daytime sleepiness and not feeling fully rested after a night's sleep.
"These findings suggest that sleep disturbances stand alone as a valid risk factor -- independent of depressed mood -- and worthy of focus as a potential [suicide] risk factor, screening and intervention tool," said lead researcher Rebecca Bernert, an instructor of psychiatry at Stanford University School of Medicine. "Compared to many other known suicide risk factors, sleep disturbances are arguably less stigmatizing and may be undone, and are highly treatable."
Among the 20 study participants who died by suicide, 19 were men. The researchers randomly matched these 20 people to 400 living participants based on shared age, sex and location, and then compared their sleep quality and depression scores.
The study couldn't prove that sleeping problems cause suicidal thoughts or attempts, nor could it explain why the link may exist. But, Bernert said, it's likely that poor sleep affects the ability to regulate moods.
"The idea is simple: when we sleep poorly, it impacts how we feel and the way in which we manage our emotions, as well as decision-making," Bernert said. Past research has shown that fragmented sleep can result in more intense negative emotions, impaired judgment and difficulty managing fear or anger.
Those who reported having poor sleep quality at the start of the study had 40 percent greater odds of dying by suicide during the next 10 years before depression symptoms had been considered. Even after making calculations to remove the effects of depression symptoms, the odds of dying by suicide were 30 percent higher for those reporting poorer sleep quality, the study authors said.
Also, those who reported not feeling well-rested after sleeping had twice the odds of dying by suicide compared to those not reporting sleeping problems, even after symptoms of depression had been considered. And sleep disturbances better predicted who died by suicide over a decade than depression symptoms did, the study authors reported in the Aug. 13 online edition of JAMA Psychiatry.
The researchers used two separate questionnaires, one on sleep quality and one on depression symptoms, for their calculations.
Yet William Kohler, medical director of the Florida Sleep Institute in Spring Hill, Fla., said he's skeptical about how well the researchers could completely account for depression symptoms since they are so similar to the symptoms of poor sleep.
"We have to ask what's the cart and what's the horse because it's not common to be really sleep-deprived and then be wide-eyed and bushy-tailed and positive about things," Kohler said.
"We know that sleep disturbance causes depressive symptoms, such as lack of energy, lack of interest in things one enjoys and feeling a little down the next day, so I'm not sure how they would separate that out," he added.
Separating them out is what the researchers said they attempted to do.
"Sleep disturbances and suicidal ideation are both symptoms -- among a constellation of symptoms -- of depression, which is why it is crucial to disentangle them as risk factors and the way in which they may interact to increase risk," Bernert said. "It is important to note that suicide is the tragic outcome of multiple, often interacting risk factors and medical conditions."
Approximately 12 out of every 100,000 people die by suicide each year in the United States. Individuals thinking about suicide can reach a nearby certified crisis center by calling the National Suicide Prevention Lifeline at 1-800-273-TALK.
The U.S. Substance Abuse and Mental Health Services Administration ranks sleep difficulties as one of the top 10 warning signs of suicide. Past studies have linked insomnia, nightmares and overall poor sleep quality to an increased risk of suicidal thoughts and attempted suicide. But those studies did not usually control for depression.
This new study differs from past research because of its size, length and focus on older Americans. The researchers tracked more than 14,000 adults, aged 65 and older, for 10 years. The adults assessed their sleep quality and depression symptoms six times during that decade.
Bernert said she and her colleagues are now investigating why the link between poor sleep and suicide might exist.
The U.S. Centers for Disease Control and Prevention and the U.S. National Institutes of Health contributed funding for the study.
http://www.medicinenet.com/script/main/art.asp?articlekey=180048
Today's short post from sciencedaily.com (see link below) falls in the category of 'duh' findings as far as most patients with severe neuropathic pain are concerned. Basically, research has shown that patients living with severe pain, internalise their resulting depression, which in turn leads to worsening of the symptoms and tendencies to catastrophise about their pain. Is there anything surprising about this? Most people with chronic pain are fully aware that their state of mind has an effect on their levels of pain and most people are quite happy to accept that a percentage of their discomfort is psychosomatic and therefore maybe feels worse at times than it actually is. Inventing new terms to describe feelings as old as the hills doesn't exactly push forward the boundaries of science and as many readers of this blog frequently point out - it can be both aggravating and frustrating for the patients themselves!
Results of an Australian study published in The Journal of Pain showed that after controlling for depression internalized stigma is negatively associated with lower levels of self-esteem and personal control of pain.
The Journal of Pain is the peer-reviewed publication of the American Pain Society, www.americanpainsociety.org.
Internalized stigma refers to the internalization or absorption of negative attitudes. It also is linked with a greater tendency to catastrophize about pain and with a reduced sense of personal control over pain. Evidence indicates that internalized stigma has negative effects on health and psychological functioning in general. Researchers from the Australian National University and the Kolling Institute of Medical Research sought to learn whether an individual's experience, perception or anticipation of negative social reactions to their pain may become internalized.
In the study, surveys were administered to 92 adults with chronic pain to explore the presence of internal stigma and its association with a range of psychological consequences in people with chronic pain.
Results showed that nearly 40 percent of the chronic pain sample reported experiencing internalized stigma. The findings showed that internalized stigma can cause low self-esteem, impaired pain self-efficacy, a greater tendency to catastrophize about pain, and a reduced sense of personal control over pain. The authors noted their findings have important implications regarding the role of internalized stigma as an outcomes measure and as a verifiable treatment target for individuals with chronic pain.
http://www.sciencedaily.nl/releases/2014/05/140530092255.htm
