Vicious circle: sleep disturbance-pain-depression-disability

Sleep disturbances are linked to pain and depression, but not disability, in people with osteoarthritis, new research highlights in Arthritis Care & Research. And poor sleep increases depression and disability, but does not worsen pain over time.
Previous research found that people with knee osteoarthritis have problems falling asleep (31%), staying asleep (81%) and general sleep problems (77%).
The new one-year study involved 288 people with knee osteoarthritis who provided information on sleep disturbances, pain, functional limitations and depressive symptoms.
Sleep was independently associated with pain and depression at the start of the study. Disability was not linked to sleep disturbances at the start of the study. People in a lot of pain found that the combination of poor sleep and pain made depressive symptoms worse. Sleep disturbance at the start of the study did predict increased depression and disability, but not pain at one-year follow-up.
“Sleep disturbance is a common complaint among those with pain, particularly among those with osteoarthritis,” explains Dr Patricia Parmelee who is involved in the research. “This study shows that depression plays a strong role in the sleep-pain connection, particularly with severe pain. Further investigation of sleep in disability progression may lead to new interventions that disrupt the cycle of osteoarthritis distress.”

Image credit: George Redgrave