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      Pain-induced depression is related to overestimation of sleep quality in a very elderly population with pain Translated title: Depressão-dor induzida está relacionada à superestimação da qualidade do sono em longevos com dor

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          Abstract

          ABSTRACT Objective: To study the quality of sleep in very elderly people with chronic pain. Methods: We investigated 51 very elderly people without dementia and with chronic pain according to the Geriatric Pain Measure. Katz and Lawton questionnaires were used to evaluate functionality. The Geriatric Depression Scale and Geriatric Psychosocial Assessment of Pain-induced Depression were also used. Self-perceptions of sleep and quality of sleep were checked using the Pittsburgh Sleep Quality Index. Results: Moderate pain was seen in 64.7% participants. The tracking of depression was positive for 41.2%. Poor quality of sleep was noted in 49% of them, but 82.3% perceived that they had a very good, or a good, sleep. The main factors associated with poor sleep quality were measurement of pain, self-perception of sleep, and pain-induced depression. Conclusion: Very elderly people with chronic pain, and without dementia, had a higher prevalence of poor sleep; however, they overestimated their sleep quality. Poor quality of sleep was associated with a poor self-perception of sleep and pain-induced depression.

          Translated abstract

          RESUMO Objetivo: Estudar a qualidade do sono em longevos com dor crônica. Métodos: Foram investigados 51 longevos sem demência e com dor crônica de acordo com o Geriatric Pain Measure. Os questionários de Katz e Lawton foram utilizados para avaliar a funcionalidade. Para o rastreio de depressão foram usados o Geriatric Depression Scale e Geriatric Psychosocial Assessment of Pain-induced Depression. Auto-percepção e qualidade do sono, de acordo com o Pittsburgh Sleep Quality Index, também foram verificados. Resultados: Dor moderada foi observada em 64,7% dos participantes. O rastreamento de depressão foi positivo para 41,2% da amostra. Má qualidade do sono foi observada em 49% deles, entretanto 82,3% dos participantes tiveram uma muito boa ou boa auto-percepção do sono. Os principais fatores associados à má qualidade do sono foram mensuração da dor, auto-percepção ruim do sono e depressão induzida por dor. Conclusão: Os longevos com dor crônica e sem demência apresentam maior prevalência de sono de má qualidade, entretanto com superestimação desta. A má qualidade do sono foi associada com auto-percepção do sono ruim e depressão induzida por dor.

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          Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey.

          To assess the association between sleep problems and chronic disease in older adults. Self-reported standardized questionnaire data from 1506 community-dwelling men and women aged 55-84 years in the continental United States who completed a 20-min telephone interview when contacted from lists of randomly selected telephone numbers. A majority of the participants (83%) reported one or more of 11 medical conditions and nearly one in four elderly respondents (age 65-84 years) had major comorbidity (i.e. four or more conditions). Depression, heart disease, bodily pain and memory problems were associated with more prevalent symptoms of insomnia. Other conditions such as obesity, arthritis, diabetes, lung diseases, stroke and osteoporosis were associated with other sleep-related problems such as breathing pauses, snoring, daytime sleepiness, restless legs or insufficient sleep (<6 h nightly). Poll findings are consistent with epidemiological studies of sleep, aging and chronic disease. These results suggest that the sleep complaints common in older adults are often secondary to their comorbidities and not to aging per se. These types of studies may be useful in promoting sleep awareness among health professionals and among older adults, especially those with heart disease, depression, chronic bodily pain or major comorbidity.
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            An epidemiologic comparison of pain complaints.

            A survey concerning common pain conditions and psychological distress was carried out among a probability sample of the adult enrollees of a large health maintenance organization in Seattle. The prevalence of pain in the prior six months was 41% for back pain; 26% for headache; 17% for abdominal pain; 12% for chest pain; and 12% for facial pain. Headache, abdominal and facial pain were less prevalent among older persons and more prevalent among females. We examined the temporal dimensions of these pain conditions, as well as intensity, treatment seeking, and activity limitation. The pain conditions were typically long standing, recurrent, of mild to moderate intensity, and usually did not limit activities. However, depending on the pain condition, 9-40% reported one or more days in the prior six months when they were unable to carry out their usual activities due to the pain problem. On average, persons with a pain condition had higher levels of anxiety, depression, and non-pain somatic symptoms as measured by the scales of the Symptom Checklist (SCL); poorer self-rating of health status; and more family stress compared to persons without a pain condition. Of these alternative measures of distress, the SCL somatization scale had the strongest independent association with pain. The increments in measures of anxiety, depression, and family stress with the presence of pain were greatest among persons with higher levels of non-pain somatic symptoms.
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              Sleep and pain: interaction of two vital functions.

              Disturbed sleep is a key complaint of people experiencing acute and chronic pain. These two vital functions, sleep and pain, interact in complex ways that ultimately impact the biological and behavioral capacity of the individual. Polysomnographic studies of patients experiencing acute pain during postoperative recovery show shortened and fragmented sleep with reduced amounts of slow wave and rapid eye movement (REM) sleep, and the recovery is accompanied by normalization of sleep. Objective assessments of sleep in patients with various chronic pain conditions have been less definitive with some studies showing fragmented and shortened sleep and others showing normal sleep. Although daytime fatigue is a frequent complaint associated with complaints of pain-related disturbed sleep, objective assessments of daytime sleepiness reveal minimally elevated levels of sleepiness and emphasize the importance of distinguishing sleepiness and fatigue. The pain-sleep nexus has been modeled in healthy pain-free subjects and the studies have demonstrated the bidirectionality of the sleep-pain relation. Given this bidirectionality, treatment must focus on alleviation of both the pain and sleep disturbance. Few of the treatment studies have done such, and as a result no clear consensus on treatment approaches, much less on differential etiology-based treatment strategies, has emerged.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo, SP, Brazil )
                0004-282X
                1678-4227
                January 2017
                : 75
                : 1
                : 25-29
                Affiliations
                [2] São Paulo São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Departamento de Psicobiologia, Ambulatório de Sonolência Excessiva Diurna Brazil
                [1] São Paulo São Paulo orgnameUniversidade Federal de São Paulo Brazil
                [3] São Paulo São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Departamento de Neurologia e Neurocirurgia Brazil
                Article
                S0004-282X2017000100025
                10.1590/0004-282x20160186
                0769a85f-042f-430d-9049-fd887179e0dd

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 12 June 2016
                : 28 September 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 5
                Product

                SciELO Brazil


                envelhecimento,sleep,dor crônica,sono,idoso,chronic pain,aging,aged
                envelhecimento, sleep, dor crônica, sono, idoso, chronic pain, aging, aged

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