Journal
JOURNAL OF PAIN
Volume 16, Issue 5, Pages 478-490Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.jpain.2015.02.004
Keywords
Quantitative sensory testing; knee osteoarthritis; insomnia; sleep; ethnicity
Categories
Funding
- AHRQ HHS [5 T32 HS013852-09, T32 HS013852, HS013852-07, T32 HS013852-07] Funding Source: Medline
- NCATS NIH HHS [UL1 TR000165, UL1 TR001427, UL1 TR001417, UL1TR000064, UL1TR000165, UL1 TR000064] Funding Source: Medline
- NIAMS NIH HHS [K23AR062099, K23 AR062099] Funding Source: Medline
- NIA NIH HHS [R01AG033906, R01 AG033906, R37 AG033906, P30 AG028740, L30 AG040467, K01 AG048259] Funding Source: Medline
- NIMHD NIH HHS [3 P60 MD000502-08S1, P60 MD000502] Funding Source: Medline
- NINDS NIH HHS [T32NS045551, T32 NS045551] Funding Source: Medline
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Studies indicate that improving sleep decreases reported pain in patients with knee osteoarthritis, but it is unclear if this association extends to experimentally induced pain responses. A community-based sample of 88 African American and 52 non-Hispanic white adults (45-76 years) with knee osteoarthritis completed the Insomnia Severity Index and the arousal subscale of the Sleep Hygiene and Practices Scale. Participants underwent quantitative sensory testing, including measures of pain sensitivity and facilitation at the knee, and pain inhibition. Outcomes were analyzed with multiple Tobit hierarchical regression models, with adjustment for relevant covariates. Ethnicity and sex by sleep interactions were also entered into the models. After covariate adjustment, main associations were not observed. However, sex interacted with insomnia severity to predict greater temporal summation of heat and punctate pressure pain among women and lower heat temporal summation among men. Men and women-who engaged in frequent arousal-associated sleep behaviors demonstrated higher and lower heat temporal summation, respectively. Non-Hispanic, whites with greater insomnia severity displayed lower pressure pain thresholds and pain inhibition. Our findings are the first to demonstrate that disrupted sleep is associated with altered pain processing differentially by sex and ethnicity/race among people with knee osteoarthritis. Perspective: This article presents the association between insomnia severity, ma/adaptive sleep behaviors, and experimentally induced pain responses among people with knee osteoarthritis. Disrupted sleep was associated with altered pain processing by sex and ethnicity/race. Offering sleep interventions may help ameliorate pain, but treatment may need to be tailored by sex and ethnicity/race. (C) 2015 by the American Pain Society
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