Sleep, Pain Catastrophizing, and Central Sensitization in Knee Osteoarthritis Patients with and Without Insomnia

Claudia Campbell, Luis F Buenaver, Patrick Hamilton Finan, Sara C. Bounds, Mary Redding, Lea McCauley, Mercedes Robinson, Robert R. Edwards, Michael T Smith

Research output: Contribution to journalArticle

Abstract

Objective Osteoarthritis (OA), a chronic degenerative joint disorder, is characterized by joint pain. Emerging research demonstrates that a significant number of patients evidence central sensitization (CS), a hyperexcitability in nociceptive pathways, which is known to amplify and maintain clinical pain. The clinical correlates of CS in OA, however, are poorly understood. Insomnia is prevalent in older adults with OA, and recent experiments suggest associations between poor sleep and measures of CS. Catastrophizing, a potent predictor of pain outcomes, has also been associated with CS, but few studies have investigated possible interactions between catastrophizing, sleep, and CS. Methods We conducted a case-control study of 4 well-characterized groups of adults with insomnia and/or knee OA. A total of 208 participants completed multimodal sleep assessments (questionnaire, diary, actigraphy, and polysomnography) and extensive evaluation of pain using clinical measures and quantitative sensory testing to evaluate associations between CS, catastrophizing, and insomnia. Descriptive characterization of each measure is presented, with specific focus on sleep efficiency and CS. Results The knee OA-insomnia group demonstrated the greatest degree of CS compared to controls. In the overall sample, we found that catastrophizing moderated the relationship between sleep efficiency and CS. Specifically those with low sleep efficiency and high catastrophizing scores reported increased levels of CS. In addition, CS was significantly associated with increased clinical pain. Conclusion These findings highlight the importance of assessing sleep efficiency, CS, and catastrophizing in chronic pain patients and have important clinical implications for treatment planning.

Original languageEnglish (US)
Pages (from-to)1387-1396
Number of pages10
JournalArthritis Care and Research
Volume67
Issue number10
DOIs
StatePublished - Oct 1 2015

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Catastrophization
Central Nervous System Sensitization
Knee Osteoarthritis
Sleep Initiation and Maintenance Disorders
Sleep
Osteoarthritis
Pain
Actigraphy
Polysomnography
Arthralgia
Chronic Pain
Case-Control Studies

ASJC Scopus subject areas

  • Rheumatology

Cite this

Sleep, Pain Catastrophizing, and Central Sensitization in Knee Osteoarthritis Patients with and Without Insomnia. / Campbell, Claudia; Buenaver, Luis F; Finan, Patrick Hamilton; Bounds, Sara C.; Redding, Mary; McCauley, Lea; Robinson, Mercedes; Edwards, Robert R.; Smith, Michael T.

In: Arthritis Care and Research, Vol. 67, No. 10, 01.10.2015, p. 1387-1396.

Research output: Contribution to journalArticle

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