New research confirms that sleep disturbances are linked to pain and depression, but not disability, among patients with osteoarthritis (OA). Study results published online ahead of print October 6 in Arthritis Care & Research found that poor sleep increases depression and disability, but does not worsen pain over time.
“Sleep disturbance is a common complaint among those with pain, particularly among those with OA,” said Patricia A. Parmelee, PhD, Director, Center for Mental Health & Aging, Professor, Department of Psychology at The University of Alabama in Tuscaloosa. “Our research is unique as we investigate the complex relationships among sleep, OA-related pain, disability and depressed mood simultaneously in a single study.”
For the study, 288 patients with knee OA provided information on pain, sleep disturbances, functional limitations, and depressive symptoms. Researchers recruited participants from diverse settings to gather a broad representation of OA subjects. Sleep disturbances at the start of the study were used to predict changes in pain, disability, and depression after a one-year period.
Findings indicated that sleep was independently associated with pain and depression at baseline. Disability was not linked to baseline sleep disturbances. In individuals with high pain levels, the combination of poor sleep and pain exacerbated depression. Sleep disturbance at baseline predicted increased depression and disability, but not pain at one-year follow-up.
“This study shows that depression plays a strong role in the sleep-pain connection, particularly with severe pain,” Dr. Parmelee and colleagues said. Further investigation of sleep in disability progression may lead to new interventions that disrupt the cycle of OA distress.”