Article2006

Sleep Impairment in Patients With Painful Diabetic Peripheral Neuropathy

Diane C. Zelman · Nancy A. Brandenburg · Mugdha R. Gore

176 citations0/0 files storedClinical Journal of Pain

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Abstract

OBJECTIVE: This study evaluated sleep impairment associated with painful diabetic peripheral neuropathy (DPN), a neuropathic pain condition. Sleep is of critical concern for DPN because sleep impairment and its comorbidities may influence type 2 diabetes progression. METHODS: This is a supplemental analysis of sleep data from a burden of illness study of patients with painful DPN (N=255, 61+/-12.8 y old, 51.4% women). Sleep was evaluated using the Medical Outcomes Study Sleep measure (MOS-Sleep). MOS-Sleep scores were compared with general population norms (N=1011), the MOS chronic disease sample (N=3445), and patients with postherpetic neuralgia (N=89). The MOS-Sleep Sleep Adequacy score was compared with data from the MOS diabetes subsample (N=590). RESULTS: Patients with painful DPN reported impaired sleep relative to the general population (P<0.001), the chronic disease sample (P<0.001), and postherpetic neuralgia patients (P<0.05). Self-rated MOS-Sleep Sleep Adequacy was significantly less for the painful DPN than for the diabetes sample (P<0.001), although self-reported hours of sleep were not significantly different. Multiple regression indicated that age, average daily pain, and anxiety and depression symptom levels were each significantly (P<0.01) associated with, and collectively accounted for, 47% of variance in the MOS-Sleep Sleep Problems Index. DISCUSSION: Painful DPN is associated with considerable sleep impairment. Given the recognized association between sleep impairment, type 2 diabetes and metabolic and affective disturbance, and the known adverse impact of affective disturbance on diabetes self-care, addressing these features-pain, sleep, and affective disturbance-is an important aspect of care for patients with painful DPN.

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References

2002The validity of the Hospital Anxiety and Depression Scale 1992Measuring Functioning and Well-Being: The Medical Outcomes Study Approach 2005Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes 2004How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature 1999Nonpharmacologic Treatment of Chronic Insomnia 2003A Prospective Study of Self-Reported Sleep Duration and Incident Diabetes in Women 2004Psychometric properties of the Medical Outcomes Study Sleep measure 2000Practice Parameters for the Evaluation of Chronic Insomnia

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2008Evaluation of the reliability and validity of the Medical Outcomes Study sleep scale in patients with painful diabetic peripheral neuropathy during an international clinical trial 2011Disturbed subjective sleep characteristics in adult patients with long-standing type 1 diabetes mellitus 2019Prevalence of Insomnia (Symptoms) in T2D and Association With Metabolic Parameters and Glycemic Control: Meta-Analysis 2019Sleep Quality in Patients With Type 2 Diabetes Mellitus

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