title: Comorbid insomnia in patients with chronic pain: a study based on the Swedish quality registry for pain rehabilitation (SQRP).
abstract: OBJECTIVE
  This study investigates the prevalence of insomnia and its relationship to other symptoms and health aspects in patients with chronic pain.
  
  
  METHODS
  Patients with chronic pain conditions (n = 845) referred to a multidisciplinary pain centre completed surveys provided by the Swedish quality registry for pain rehabilitation (SQRP). The SQRP collects data on socio-demographics, health status, symptoms of pain, mood and insomnia and life satisfaction.
  
  
  RESULTS
  The majority of patients (65.3%) had clinical insomnia according to the insomnia severity index (ISI). Insomnia correlated significantly but weakly with pain, depression, anxiety and coping; the strongest multivariate correlations were found with depression and anxiety followed by pain interference and pain severity. Pain intensity, depression and anxiety correlated stronger than ISI with respect to the two investigated aspects of health.
  
  
  CONCLUSIONS
  The prevalence of insomnia is high in patients with chronic pain conditions, but the level of importance in relation to other symptoms for health aspects is low, and the associations with other important symptoms are relatively weak. One way to increase the effects of multimodal rehabilitation programs may be to provide interventions directed specifically at insomnia rather than focusing only on interventions that address pain, depression and anxiety. Implications for Rehabilitation The prevalence of insomnia is high in patients with complex chronic pain conditions. Relatively low correlations existed between insomnia and pain intensity, depression, anxiety and other psychological aspects. Pain intensity, anxiety and depression were more important for perceived health aspects than insomnia. One way to increase the effects of multimodal rehabilitation programs may be to also include interventions directed directly to insomnia.
authors: Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Rehabilitation Medicine, University of Linköping , Linköping , Sweden and.
authors: Peter
authors: P
authors: Alföldi
authors: Tobias
authors: T
authors: Wiklund
authors: Björn
authors: B
authors: Gerdle
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000150:complications / Q000453:epidemiology; D059350:Chronic Pain / Q000150:complications*; D003863:Depression / Q000150:complications / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D015995:Prevalence; D011788:Quality of Life; D012042:Registries; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: Anxiety; chronic pain; depression; health; human; insomnia; insomnia severity index