Insomnia and caregiver burden in chronic pain patients: A cross-sectional clinical study

PLoS One. 2020 Apr 2;15(4):e0230933. doi: 10.1371/journal.pone.0230933. eCollection 2020.

Abstract

Insomnia is a major comorbid symptom of chronic pain and is likely to affect caregiver burden. This cross-sectional study investigated the association between insomnia in chronic pain patients and family caregiver burden. Participants were 60 patients with chronic pain of ≥3 months duration. Demographic and clinical information were collected using the Athens Insomnia Scale (AIS), the Pain Disability Assessment Scale (PDAS), the Hospital Anxiety and Depression Scale (HADS), and a pain intensity numerical rating scale (NRS). Family members who accompanied chronic pain patients to hospital completed the Zarit Burden Interview (ZBI). Univariate regression analysis and multiple regression analysis were conducted to clarify the associations between ZBI scores and total/subscale AIS scores. Covariates were age; sex; pain duration; and scores on the PDAS, HADS anxiety subscale, HADS depression subscale, and NRS. Insomnia was independently associated with ZBI scores [β: 0.27, 95% confidence interval (CI): 0.07-0.52, p = 0.001]. Scores on the AIS subscale of physical and mental functioning during the day were significantly associated with ZBI scores (β: 0.32, 95% CI: 0.05-0.59, p = 0.007). In conclusion, the findings suggest that in chronic pain patients, comorbid insomnia and physical and mental daytime functioning is associated with family caregiver burden independently of pain duration, pain-related disability, and pain intensity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological / physiology
  • Aged
  • Anxiety / psychology
  • Caregivers / psychology*
  • Caregivers / statistics & numerical data*
  • Chronic Pain / physiopathology*
  • Chronic Pain / psychology*
  • Cost of Illness
  • Cross-Sectional Studies
  • Depression / psychology
  • Disability Evaluation
  • Disabled Persons / psychology
  • Family / psychology
  • Female
  • Humans
  • Male
  • Pain Measurement / statistics & numerical data
  • Quality of Life / psychology
  • Sleep Initiation and Maintenance Disorders / physiopathology*
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Surveys and Questionnaires

Grants and funding

The principal author and one coauthor have been employed by a pharmaceutical company (Pfizer Japan). However, the present study has no financial or other relationships with that company as it was entirely sponsored by and performed within Juntendo University using anonymous patient data. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Pfizer provided support in the form of salaries for authors MY and YK, but did not have any additional role in the study design, data collection and analysis, or publication or preparation of the manuscript. The specific roles of these authors (MY and YK) are articulated in the “Author contributions” section.