Sleep plays a vital role in maintaining our mental and physical health. Naturally,
not being able to sleep well could be a major source of distress. Indeed insomnia
is amongst the most prevalent psychological health complaints, with at least
1 in every 10 adults suffering from insomnia chronically1-2. Untreated insomnia
could have serious health consequences, not only in terms of day-to-day functioning
(e.g., impaired concentration, memory and mood) 3 but also in terms of increasing
the risk of developing a psychological/medical problem in the long run (e.g.,
depression, anxiety, substance dependency) 4. In a recent study by our group5
we note that above 50% of the patients seeking treatment at a pain management
centre meet criteria for clinical insomnia. Based on this finding, our group
now are starting a programme of research identifying the factors driving sleep
disturbance in chronic pain and investigating the relationship between sleep
Funder: Croucher Foundation Hong Kong (www.croucher.org.hk)
Pain intensity and disability in chronic pain have recently been linked to pain-related rumination. However, while rumination is commonly observed in chronic pain patients, the nature of rumination in chronic pain is poorly defined and the mechanisms through which rumination may act to increase pain and disability remain unspecified. Semi-structured interviews were conducted with 20 chronic pain patients in order to establish the phenomenology of rumination in chronic pain and generate testable hypotheses for empirical investigation. Extracted themes included: rumination is triggered by pain and negative emotion (and vice versa), positive beliefs about rumination, negative beliefs about the self, rumination precedes and affects sleep. A number of interesting differences were found between a minority of participants who were identified as infrequent ruminators and the rest of the sample.
Status: This paper is currently under review by the European Journal of Pain
Given the suggestion of a reciprocal relationship between sleep and pain and the recognition of sleep as an important parameter in determining quality of life, there is increasing interest in sleep disturbance linked to chronic pain. The present study aimed to provide an estimate of the prevalence of 'clinical insomnia' in patients attending a specialist pain clinic and identify factors associated with it. Seventy chronic back pain patients and 70 gender- and age-matched pain-free controls completed a set of questionnaires measuring sleep, pain and a selection of general and specific psychological variables. Scores suggestive of clinical insomnia were noted in 53% of chronic pain patients as compared to only 3% in pain-free controls. Among the pain and psychological variables examined, the tendency to interpret pain in affective terms and the level of health anxiety were the best predictors of insomnia severity, even when pain intensity was controlled for.
Status: This paper has now been published in the Journal of Sleep Research.