The association between sleep quality, preoperative risk factors for chronic postoperative pain and postoperative pain intensity 12 months after knee and hip arthroplasty

Background: Chronic postoperative pain following total joint replacement (TJA) is a substantial clinical problem, and poor sleep may affect predictive factors for postoperative pain, such as pain catastrophizing. However, the magnitude of these associations is currently unknown. This exploratory study investigated (1) the relationship between preoperative sleep quality, clinical pain intensity, pain catastrophizing, anxiety, and depression and (2) their associations with chronic postoperative pain following TJA. Methods: This secondary analysis from a larger randomized controlled trial included rest pain intensity (preoperative and 12 months postoperative; visual analogue scale, VAS), preoperative Pittsburgh Sleep Quality Index (PSQI), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS) data from 74 knee and 89 hip osteoarthritis (OA) patients scheduled for TJA. Poor sleepers were identified based on preoperative PSQI scores higher than 5. Results: Poor sleepers demonstrated higher preoperative VAS, pain catastrophizing, anxiety, and depression compared with good sleepers (all p < 0.003). Preoperative PSQI (β = 0.23, p = 0.006), PCS (β = 0.44, p < 0.005), and anxiety (β = 0.18, p = 0.036) were independent factors for preoperative VAS. Preoperative VAS (β = 0.32, p < 0.005), but not preoperative sleep quality (β = −0.06, p = 0.5), was an independent factor for postoperative VAS. Conclusion: The OA patients reporting poor preoperative sleep quality show higher preoperative pain, pain catastrophizing, anxiety, and depression. High preoperative pain intensity, but not poor sleep quality, was associated with higher chronic postoperative pain intensity. Future studies are encouraged to explore associations between sleep and chronic postoperative pain.

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The influence of pre- and perioperative administration of gabapentin on pain 3–4 years after total knee arthroplasty

Scandinavian Journal of Pain ◽

10.1515/sjpain-2018-0027 ◽

2018 ◽

Vol 18 (2) ◽

pp. 237-245 ◽

Cited By ~ 5

Author(s):

Kristian Kjær Petersen ◽

Troels Haxholdt Lunn ◽

Henrik Husted ◽

Lars Tambour Hansen ◽

Ole Simonsen ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Postoperative Pain ◽

Knee Arthroplasty ◽

Pain Catastrophizing ◽

Depression Scale ◽

Psychological State ◽

Chronic Postoperative Pain ◽

Preoperative Pain ◽

Pain Scores ◽

Total Knee

AbstractBackground and aims:Approximately 20% of patients having total knee arthroplasty (TKA) will experience chronic postoperative pain. Recently, preoperative pain facilitation has been associated with chronic pain after TKA, and gabapentin has been shown to decrease pain facilitation. The current study is a secondary follow-up of a primary RCT investigating the effect of gabapentin on acute postoperative pain after TKA and exploring the effect of pre- and perioperative administration of gabapentin on chronic postoperative pain and psychological state 3–4 years after TKA.Methods:Patients scheduled for TKA were randomized to either gabapentin 1,300 mg/day, gabapentin 900 mg/day, or placebo daily from 2-h before and 6 days after operation. Pre- and 3–4 years postoperatively pain scores related to pain while walking, at rest, when flexing the hip or the knee were collected. At the same time, the pain catastrophizing scale (PCS) and hospital anxiety and depression scale subscales for anxiety (HADS-A) and depression (HADS-D) were collected.Results:Lower postoperative pain while walking, flexing the hip, and at rest were found compared with preoperative scores (p<0.03), but these were not associated with gabapentin treatment (p>0.19). Significantly lower postoperative PCS and HADS-A scores were seen compared with preoperative scores (p<0.001), but these were not associated with gabapentin treatment (p>0.55).Conclusions:The current study found that pre- and perioperative administrations of gabapentin do not influence the pain or psychological state 3–4 years after TKA.Implications:The current study does not support that short-term pre- and perioperative use of gabapentin can reduce the development of chronic postoperative pain after TKA.

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Prevalence and risk factors of restless legs syndrome in patients of migraine without aura

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20195169 ◽

2019 ◽

Vol 6 (6) ◽

pp. 1706

Author(s):

Karthik Nagaraj ◽

Ramesh Patil

Keyword(s):

Sleep Quality ◽

Restless Legs Syndrome ◽

Migraine Without Aura ◽

Rating Scale ◽

Depression Scale ◽

Anxiety And Depression ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Restless Legs ◽

Midas Questionnaire

Background: An association between migraine and Restless Legs Syndrome (RLS) has been proposed due to shared dopaminergic dysfunction. Both have substantial effects on the quality of life. Identifying co morbidities of migraine helps in optimizing patient management. Objectives To study the prevalence of RLS in patients of migraine without aura, and associated co morbidities of RLS.Methods: This was a hospital based prospective observational study. All patients diagnosed as Migraine without aura as per ICHD-3 criteria completed the questions regarding migraine headache, Migraine Disability Assessment (MIDAS) questionnaire, Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI) and International RLS Study Group (IRLSSG) Rating Scale. RLS was diagnosed using the IRLSSG criteria. Serological investigations were done to look for secondary causes of RLS.Results: Out of 200 consecutive patients of migraine without aura were included in the study over a period of 18 months. Frequency of RLS was 13.5% (n=27). All patients had primary RLS. Mean PSQI score was higher in the patients of migraine without aura with RLS than in non RLS patients of migraine without aura (3.30±2.66 vs 2.24±2.03 p≤0.0168). Poor sleep quality, anxiety, depression was found in 9%, 8% and 2.5% respectively in patients of migraine without aura.Conclusions: An association between migraine without aura and RLS was demonstrated. Migraine without aura was associated with increased frequency of poor sleep quality, anxiety and depression.

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Anxiety and Depression Affect Early Postoperative Pain Dimensions after Bariatric Surgery

Journal of Clinical Medicine ◽

10.3390/jcm10010053 ◽

2020 ◽

Vol 10 (1) ◽

pp. 53

Author(s):

Sofia Gravani ◽

Maria Matiatou ◽

Pantelis T. Nikolaidis ◽

Evangelos Menenakos ◽

Constantinos G. Zografos ◽

...

Keyword(s):

Bariatric Surgery ◽

Postoperative Pain ◽

Short Form ◽

Depression Scale ◽

Preoperative Anxiety ◽

Anxiety And Depression ◽

Mcgill Pain Questionnaire ◽

Preoperative Pain ◽

Prolonged Hospitalization ◽

Prolonged Immobilization

Uncontrolled postoperative pain and prolonged immobilization after bariatric surgery have been associated with increased postoperative complications and prolonged hospitalization. The aim of our study was to evaluate the postoperative pain that follows bariatric surgery and identify any psychological factors that may affect the early postoperative perception of pain. The study included 100 patients with obesity (women, n = 61; age 37.4 ± 9.9 years, mean ± standard deviation; Body Mass Index (BMI) 47.6 ± 6.5 kg/m2) who underwent bariatric surgery. Preoperative anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale (HADS), and the quantitative and qualitative dimension of early postoperative pain were evaluated by the McGill Pain Questionnaire Short Form (MPQ-SF). Furthermore, the postoperative analgesia protocol was recorded for each patient. Pain declined gradually during the first 24 h postoperative. Although preoperative anxiety had no correlation with the overall pain of postoperative Day 0, patients with a higher level of preoperative anxiety had significantly more intense and more unpleasant pain at 1 h post operation. In addition, depression influences both the intensity and unpleasantness of pain at different time points (1 h, 4 h and 24 h postoperative). Preoperative pain correlated with educational level, but not with age, BMI, gender, marital status, smoking and surgery type. In conclusion, preoperative anxiety and depression influence the early postoperative pain after bariatric surgery, and their preoperative identification is of major importance to enhance the implementation of fast-track postoperative protocols to prevent complications and prolonged hospitalization.

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Sleep disorders, depression and anxiety among medicine university students in Sfax

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.704 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s268-s269

Author(s):

M. Moalla ◽

M. Maalej ◽

C. Nada ◽

R. Sellami ◽

J. Ben Thabet ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Depressive Disorders ◽

Depression Scale ◽

Tunisian Population ◽

Anxiety And Depression ◽

Average Score ◽

Poor Sleep ◽

Depression And Anxiety ◽

Cross Sectional

IntroductionSleep symptoms, depression and anxiety often coexist and tertiary students are a population group that are increasingly recognised to be at risk. However the rates of these conditions in the tunisian population are poorly understood.AimThe aim of this study was to evaluate sleep quality among medicine students during exam periods and identify correlations with anxiety and depression.MethodsThis is a descriptive and analytical cross-sectional study. It involved students of medicine University of Sfax during the period of exams. Each student filled out demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI) to assess the quality of sleep and Hospital Anxiety and Depression scale (HAD) to screen for anxiety and depressive disorders.ResultsThe average age was 22.27 years. The sex ratio M/F was 0.66. The students were single in 96.7% of cases. The average score of PSQI was 6.67 ± 3.23. According to the PSQI, 53.3% of students had poor sleep quality. The anxiety score ranged from 0 to 7 with an average of 8.37. The depression score ranged from 0 to 16 with an average of 7.47. Anxiety and depressive symptoms were present in 26.7% of students. The PSQI score was significantly correlated with anxiety (p <0.01) and depression scores (P = 0.019).ConclusionAnxiety and depressive symptoms are common among students during exam periods. They are associated with poor quality sleep. The establishment of a helpline for students during exam time, with psychologists and psychiatrists, would help them better manage this difficult period.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The Association Between Preoperative Pain Catastrophizing and Postoperative Pain Intensity in Cardiac Surgery Patients

Pain Medicine ◽

10.1111/j.1526-4637.2012.01386.x ◽

2012 ◽

Vol 13 (6) ◽

pp. 820-827 ◽

Cited By ~ 34

Author(s):

Reenam S. Khan ◽

Petros Skapinakis ◽

Kamran Ahmed ◽

Demetrios C. Stefanou ◽

Hutan Ashrafian ◽

...

Keyword(s):

Cardiac Surgery ◽

Postoperative Pain ◽

Pain Intensity ◽

Pain Catastrophizing ◽

Preoperative Pain

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Serum Kynurenines Correlate With Depressive Symptoms and Disability in Poststroke Patients: A Cross-sectional Study

Neurorehabilitation and Neural Repair ◽

10.1177/1545968320953671 ◽

2020 ◽

Vol 34 (10) ◽

pp. 936-944 ◽

Cited By ~ 3

Author(s):

Paul Carrillo-Mora ◽

Verónica Pérez-De la Cruz ◽

Berenice Estrada-Cortés ◽

Paola Toussaint-González ◽

José Antonio Martínez-Cortéz ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Barthel Index ◽

Depression Scale ◽

Functional Independence ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Poor Sleep ◽

Cross Sectional ◽

Potential Marker

Background Poststroke depression (PSD) is related to adverse functional and cognitive prognosis in stroke patients. The participation of kynurenine pathway metabolites in depression has been previously proposed; however, there are few studies on its role in PSD and disability in stroke. Objective To investigate if there is a correlation between serum kynurenines levels with poststroke anxiety and depression symptoms and disability scales. Methods A cross-sectional case-control study was conducted in patients with first stroke, of >1 month and <1 year of evolution, with no history of previous psychiatric or neurological disorders; the Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment (MoCA), functional evaluations (Barthel index, Functional Independence Measure [FIM]) were applied and serum kynurenines (Kyns) were determined. Results Sixty patients were included; significant depressive symptoms were found in 63% of the cases; a significant and positive correlation was obtained between levels of 3-hydroxykynurenine (3-HK) with HADS-T ( r = 0.30, P = .025) and HADS-D ( r = 0.28, P = .039). Depressed patients showed significantly higher levels of 3HK ( P = .048) and KYNA ( P = .0271) than nondepressed patients; the 3HK levels were inversely correlated with functional scales: Barthel index ( r = −0.31, P = .02), FIM ( r = −0.40, P = .01); in addition, serum 3HK levels were significantly higher in patients with poor sleep quality ( P = .0190). Conclusions Serum Kyns show correlation with the presence and severity of depressive symptoms and with the disability and sleep quality. Kyns may be a potential marker of depression risk and disability in stroke in future.

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Sleep disturbance among frontline nurses during the COVID-19 pandemic

Sleep and Biological Rhythms ◽

10.1007/s41105-021-00337-6 ◽

2021 ◽

Author(s):

Mohammed Al Maqbali

Keyword(s):

Logistic Regression ◽

Sleep Quality ◽

Sleep Disturbance ◽

Depression Scale ◽

Disease Outbreaks ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Poor Sleep ◽

Poor Sleep Quality

AbstractThe main objective of this study is to assess the prevalence of sleep disturbance and related psychological factors (stress, anxiety and depression) among frontline nurses in Oman during the COVID-19 pandemic. A cross-sectional and descriptive correlational design using Qualtrics® software was used in this research. Data were collected using the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS). Logistic regression was performed to identify factors associated with poor sleep quality. Of the 987 frontline nurses who participated, 58.8% (n = 580) reported poor sleep quality. In an examination of PSQI components the mean sleep duration was 7.04 (SD = 1.59) hours per night, and the sleep latency mean was 38.18 min (SD = 31.81). Poor sleep (p < .05) was significantly associated with age, marital status, years of experience, comorbidity, and whether family members or relatives were suspected or confirmed with having COVID-19. Logistic regression showed that poor quality of sleep was significantly associated with stress, anxiety and depression symptoms. Sleep disturbance is a significant problem for frontline nurses working in Oman during the COVID-19 pandemic. Appropriate interventions to maintain the health conditions and reduce sleep disturbance among frontline nurses are needed in order to help support nurses’ work during contagious disease outbreaks. These can be implemented through online workshops and training to enhance nurses’ responses to the pandemic or to any further disease outbreaks.

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Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis

BMC Nephrology ◽

10.1186/s12882-021-02349-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Zakariya Al Naamani ◽

Kevin Gormley ◽

Helen Noble ◽

Olinda Santin ◽

Mohammed Al Maqbali

Keyword(s):

Logistic Regression ◽

Sleep Quality ◽

Depression Scale ◽

Anxiety And Depression ◽

Poor Sleep ◽

Hospital Anxiety ◽

Cross Sectional ◽

Correlational Design ◽

Anxiety Depression

Abstract Objective Patients undergoing haemodialysis may experience troubling symptoms such as fatigue, anxiety, depression and sleep quality, which may affect their quality of life. The main objective of this study is to determine the prevalence of fatigue, anxiety, depression and sleep quality among patients receiving haemodialysis during the coronavirus disease 2019 (COVID-19) pandemic, and to explore the contributing predictors. Methods A cross-sectional and descriptive correlational design using Qualtrics software was performed. Data were collected using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression analyses were used to explore the predictors that were associated with fatigue, anxiety, depression and sleep quality. Results Of the 123 patients undergoing haemodialysis who participated, 53.7% (n = 66) reported fatigue, 43.9% (n = 54) reported anxiety, 33.3% (n = 41) reported depression and 56.9% (n = 70) reported poor sleep. Fatigue, anxiety and sleep quality (P < .05) were significantly associated with being female, and whether family members or relatives were suspected or confirmed with COVID-19. Logistic regression showed that being within the age group 31–40, having a secondary education level, anxiety, depression and sleep quality were the main predictors affecting the fatigue group. Conclusion Fatigue, anxiety, depression and sleep quality are significant problems for patients receiving haemodialysis during the COVID-19 pandemic. Appropriate interventions to monitor and reduce fatigue, psychological problems and sleep quality amongst these patients are needed. This can help to strengthen preparations for responding to possible future outbreaks or pandemics of infectious diseases for patients receiving haemodialysis.

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Sleep Quality in Chronic Pain Patients

The Canadian Journal of Psychiatry ◽

10.1177/070674370204700905 ◽

2002 ◽

Vol 47 (9) ◽

pp. 844-848 ◽

Cited By ~ 71

Author(s):

Kemal Sayar ◽

Meltem Arikan ◽

Tulin Yontem

Keyword(s):

Chronic Pain ◽

Sleep Quality ◽

Pain Intensity ◽

Anxiety And Depression ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Control Subjects ◽

Chronic Pain Patients ◽

Healthy Control ◽

Pain Patients

Objective: Chronic pain patients have been reported to complain about poor sleep quality. Research aimed at delineating the predictors of poor sleep has produced conflicting results. Depressive mood and pain severity are the most frequently encountered predictors. This study aimed to find out whether chronic pain patients differed from healthy control subjects who had no pain on subjective sleep quality measures and, if so, which factors contributed most to poorer sleep quality. Method: We compared 40 patients with chronic pain who met inclusion criteria with 40 healthy control subjects on the measures of sleep quality, anxiety, and depression. The predictors of sleep quality were investigated with multiple regression in the pain group. Results: Chronic pain patients had higher scores than did healthy control subjects on the Beck Anxiety Scale, the Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI). At the bivariate level, pain intensity, anxiety, and depression correlated significantly with poorer sleep quality. At the multivariate level, depression was found to be the only significant factor correlating with the quality of sleep, and the model explained 34% of the variance. Conclusions: Chronic pain patients suffer from poor sleep quality—a function of depressed mood rather than pain intensity, duration, or anxiety. However, it is difficult to draw a causal relation in this relatively small sample size. Besides, our study sample comprised a mostly psychiatric population and may not represent the general group of patients with chronic pain.

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The Role of Pain Catastrophizing in the Prediction of Acute and Chronic Postoperative Pain

The Open Pain Journal ◽

10.2174/1876386301306010176 ◽

2013 ◽

Vol 6 (1) ◽

pp. 176-182 ◽

Cited By ~ 7

Author(s):

Ran Kremer ◽

Michal Granot ◽

David Yarnitsky ◽

Yonathan Crispel ◽

Shiri Fadel ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Intensity ◽

Prospective Observational Study ◽

Pain Catastrophizing ◽

Pain Catastrophizing Scale ◽

Chronic Postoperative Pain ◽

Unique Role ◽

Relative Contribution ◽

Postthoracotomy Pain

Background and Objectives: Despite the established association between greater pain catastrophizing and enhanced postoperative pain, it is still unclear: (i) what is the relative contribution of each of the pain catastrophizing scale (PCS) dimensions in the prediction of acute and chronic postoperative pain; and (ii) whether PCS scores mediate the association between acute and chronic postoperative pain intensity. Methods: The current prospective, observational study was conducted at Rambam Health Care Campus, Haifa, Israel. PCS was obtained in 48 pain-free patients a day before an elective thoracotomy in response to tonic heat pain. Acute postthoracotomy pain (APTP) was assessed during rest, including general pain (Restgeneral), and incision-related pain (Restincision), and in response to provoked physical activity, including hand elevation (Provokedhand) and cough (Provokedcough). Chronic postthoracotomy pain (CPTP) was assessed after 4.5±2.3 months. Results: Of the PCS subscales, only rumination: (i) was correlated with Restgeneral scores (r=0.337, P=0.027); and (ii) predicted chronic postthoracotomy pain in a regression analysis (P=0.001). General PCS and its subscales mediated the correlation between Restgeneral and chronic postthoracotomy pain intensity (Ps<0.006). Conclusions: Findings may elucidate the unique role of the rumination subscale in reflecting an individual's postopertive acute and chronic pain responsiveness. The transition from acute to chronic postoperative pain seems to be facilitated by enhanced pain catastrophizing.

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