title: Assessing and Managing Sleep Disturbance in Patients with Chronic Pain.
abstract: Chronic pain is associated with symptoms that may impair a patient's quality of life, including emotional distress, fatigue, and sleep disturbance. There is a high prevalence of concomitant pain and sleep disturbance. Studies support the hypothesis that sleep and pain have a bidirectional and reciprocal relationship. Clinicians who manage patients with chronic pain often focus on interventions that relieve pain, and assessing and treating sleep disturbance are secondary or not addressed. This article reviews the literature on pain and co-occurring sleep disturbance, describes the assessment of sleep disturbance, and outlines nonpharmacologic and pharmacologic treatment strategies to improve sleep in patients with chronic pain.
authors.affiliation: Department of Psychiatry, Center for Studies of Addiction, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA 19104, USA; Department of Psychiatry, Behavioral Medicine Center, Reading Health System, 560 Van Reed Road, Suite 204, Wyomissing, PA 19610, USA. Electronic address: cheatle@mail.med.upenn.edu.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Cheatle
authors.affiliation: Kirby Center for Neurobiology, 3 Blackfan Circle, CLS 12-260, Boston, MA 02115, USA.
authors.forename: Simmie
authors.initials: S
authors.lastname: Foster
authors.affiliation: Department of Psychiatry, Center for Studies of Addiction, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA 19104, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Pinkett
authors.affiliation: RA Pain Services, 1500 Midatlantic Drive Suite 102, Mount Laurel, NJ 0854, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Lesneski
authors.affiliation: Highpoint Pain and Rehabilitation Physicians P.C., 700 Horizon Circle Suite 206, Chalfont, PA 18914, USA.
authors.forename: David
authors.initials: D
authors.lastname: Qu
authors.affiliation: MJHS Institute for Innovation in Palliative Care, 39 Broadway, 3rd Floor, New York, NY 10006, USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Dhingra
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D059350:Chronic Pain / Q000150:complications*; D015928:Cognitive Behavioral Therapy; D058785:GABA-A Receptor Agonists / Q000627:therapeutic use; D006801:Humans; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy
chemical_list: D000701:Analgesics, Opioid; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D058785:GABA-A Receptor Agonists
keywords: Chronic pain; Cognitive behavior therapy; Insomnia; Pharmacotherapy; Sleep-disordered breathing