Study elucidates interplay between sleep and time

Often debilitating chronic pain is one of the most common reasons individuals seek medical help. Approximately 65 million adults in the United States suffer from chronic pain. 67-88% of them also suffer from sleep disorders, such as longer, more frequent nighttime awakenings and poor sleep quality. Additionally, sleep disturbances can also exacerbate pain by contributing to the development of obesity, diabetes mellitus, and depression.

Chronic pain and sleep are thought to be correlated, so treatment for one may benefit the other. One such treatment is spinal cord stimulation, which improves aspects of sleep and there is growing evidence that it has shown efficacy in treating a number of chronic pain conditions. This treatment includes an implanted spinal cord stimulator that sends low-level electricity directly to the spinal cord to relieve pain. However, the impact on patients’ lives has yet to be determined.

researchers from Florida Atlantic Universityof Schmidt College of Medicine, Albany Medical Centerconducted a study to better understand the effects of spinal cord stimulation on chronic pain and sleep.

In this study, participants completed a series of accredited outcome measures for sleep, pain, functional status, and overall quality of life at various time periods during the study. These investigations were performed preoperatively and 6 months or 1 year after surgery. Participants were also asked about their satisfaction with the spinal cord stimulation procedure and whether they would undergo surgery again.

Researchers examined relationships between pain outcome measures using the Insomnia Severity Index, a clinical screening tool that assesses the severity of both nighttime and daytime components of insomnia. Using this tool, we established the minimal clinically significant difference, that is, the smallest noticeable change that a patient perceives as clinically significant and may indicate a change in management. Minimal clinically important differences are particularly useful for evaluating new treatments, as the cohorts to compare for statistical significance are small.

Research published in journals Stereotactic and functional neurosurgery, We successfully established a range of minimal, clinically important differences in the Insomnia Severity Index outcome measure to help measure improvement in insomnia after spinal cord stimulation.

The results showed that 39.1% of participants had an improvement of 30% or more on the Insomnia Severity Index, and 28.1% of participants had an improvement of 30% or more on the Epworth Sleepiness Scale. Minimum clinically important difference values ​​of 2.4 to 2.6 correlated with improvement in participants’ disability and depression. The study found associations between sleep and both pain and depression, but no correlation between sleep and spinal cord stimulation success.

“The physiological mechanisms of both pain and sleep are complex and the relationship between the two is poorly understood. Julie Pyritis, MD, Ph.D., Senior Author, Dean and Vice-Chancellor, Faculty of Medicine, FAU Schmidt Medical College. “Recognizing the intersection of sleep disorders and chronic pain can lead to a more focused treatment plan, which can lead to significant improvements in overall health beyond improvements in sleep and pain alone.” .”

Successful spinal cord stimulation was measured by preoperative scores and changes in scores 6 to 12 months after surgery. For the Insomnia Severity Index, he asks seven questions to assess an individual’s level of insomnia, with higher scores indicating more trouble sleeping at night. The Epworth Sleepiness Scale quantifies daytime sleepiness based on a patient’s likelihood of falling asleep during her eight daily activities, with higher scores indicating increased daytime sleepiness. To determine which patients had improved sleep, researchers looked at her improvement of 30% or more on the Insomnia Severity Index or the Epworth Sleepiness Scale.

“Because it’s important to consider the interaction between sleep and chronic pain in patients undergoing spinal cord stimulation, relevant sleep states were included in the analysis in our study,” said Pilitsis. says. FAU Stiles-Nicholson Brain Institute“As more research is conducted on the threshold of minimal clinically important difference, the assessment of clinical response to spinal cord stimulation will improve. We can better understand the types of patients who are high.”

The co-author of the study is Phillip M. Johansen, a fourth-year medical student at FAU. Frank A. Trujillo, third year FAU medical school. Vivian Hagerty, MD, General Surgery Resident at FAU. FAU Schmidt Medical College. Neurosurgeon Tessa Harland, MD. and Gregory Davis, MD, both at Albany Medical Center.

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About Charles E. Schmidt College of Medicine:

FAU’s Charles E. Schmidt College of Medicine is one of approximately 156 accredited medical schools in the United States. The university was launched in his 2010, When the Board of Governors of Florida made a landmark decision to authorize FAU to award an MD degree. Approved by the Florida Legislature and Governor to become her 134th allopathic medical school in North America.When 70+ full-time and part-time faculty and 1,300+ affiliated faculty, the is in college It enrolls 64 medical students each year and is nationally recognized for its innovative curriculum. To further the FAU’s commitment to increasing the much-needed medical residency jobs in Palm Beach County and to ensure the region continues to have an adequate and well-trained workforce of physicians, FAU Charles E. The Schmidt School of Medicine Graduate Medical Education Consortium (GME) was established in the fall of 2011 with five major hospitals in Palm Beach County. The consortium currently has five Accreditation Council for Graduate Medical Education (ACGME) accredited residents, including internal medicine, surgery, emergency medicine, psychiatry and neurology. Active research areas at the university include healthy aging, neuroscience, chronic pain management, precision medicine, and machine learning. With the community at the forefront, the university offers locals a range of evidence-based clinical services that treat the whole person. FAU Medicine’s Primary Care Practice and the Marcus Institute of Integrative Health are jointly designed to provide complete health and wellness under one roof.

About Florida Atlantic University:
Founded in 1961, Florida Atlantic University officially opened in 1964 as Florida’s fifth public university. Today, the university serves more than 30,000 undergraduate and graduate students at her six campuses along the southeastern coast of Florida. In recent years, the university has doubled its research spending and has outperformed its peers in student achievement. Through the coexistence of access and excellence, FAU embodies an innovative model that closes the traditional performance gap. FAU is a designated Hispanic institution, ranked as a top public university by US News & World Report, and ranked as an institution of high research activity by the Carnegie Foundation for the Advancement of Education. For more information, see: www.fau.edu.