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THU0720-HPR Factors associated with poor sleep quality in patients with chronic widespread pain: results from the amsterdam pain cohort
  1. A. de Rooij1,
  2. M. van der Leeden2,
  3. L.D. Roorda1,
  4. M. Rinkema3,
  5. W. Beuving3,
  6. J. Dekker4
  1. 1Department of Rehabilitation Medicine, Amsterdam Rehabilitation Research Center | Reade, Amsterdam
  2. 2Department of Rehabilitation Medicine, VU University Medical Centre
  3. 3Department of Rehabilitation Medicine, Reade center for rehabilitation and rheumatology
  4. 4Department of Psychiatry, VU University Medical Centre, Amsterdam, Netherlands


Background Reduced sleep quality is a major concern in patients with chronic widespread pain (CWP).1 2 Poor sleep quality in CWP has received relatively little attention in both multidisciplinary treatment and clinical research in multidisciplinary treatment.3 4

Objectives (i) To investigate the prevalence of poor sleep quality and (ii) to explore the associations between clinical, cognitive and emotional factors and quality of sleep in patients with CWP indicated for multidisciplinary treatment.

Methods Baseline data were used from 163 CWP patients referred for multidisciplinary treatment. Linear regression models, adjusted for age and gender, were used to assess the relationship of clinical (pain, fatigue, pain interference and disability), emotional (anxiety, depression and psychological distress) and cognitive factors (catastrophizing, acceptance, self-efficacy, kinesiofobia and illness beliefs) with sleep quality, as measured with the Pittsburgh Sleep Quality Index (PSQI).

Results Poor sleep quality was found in 92% of the patients. The multivariate model showed that a higher level of fatigue, psychological distress and more concerns about the illness were independently associated with poorer quality of sleep. The model explained 27.9% of the variance of sleep quality.

Conclusions The high prevalence of poor sleep quality in patients with CWP referred for multidisciplinary treatment emphasises the need to target sleep during the treatment program. Poorer quality of sleep is related to a higher level of fatigue, psychological distress and more concerns about the illness. Attention to these factors during multidisciplinary treatment could contribute to improvement in quality of sleep.

References [1] Breivik H, Collett B, Ventafridda V, et al. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain2006;10(4):287–333.

[2] Arnold LM, Crofford LJ, Mease PJ, et al. Patient perspectives on the impact of fibromyalgia. Patient Educ Couns2008;73(1):114–20.

[3] Scascighini L, Toma V, Dober-Spielmann, et al. Multidisciplinary treatment for chronic pain: a review of inter ventions and outcomes. Rheumatology (Oxford)2008;47(5):670–678.

[4] Dworkin RH, Turk DC, Farrar JT, et al. core outcome measures for chronic pain clinical trials:IMMPACT recommendation. Pain2005;113(1–2):9–19.

Disclosure of Interest None declared

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