The pain-depression dyad and the association with sleep dysfunction in chronic rhinosinusitis

• Type of Material: Article
• Authors: Daniel Cox, Emory University; Shaelene Ashby, University of Utah; Jess C. Mace, Oregon Health & Science University; John DelGaudio, Emory University; Timothy L. Smith, Oregon Health & Science University; Richard R. Orlandi, University of Utah; Jeremiah A. Alt, University of Utah
• Language: English
• Date: 2017-01-06
• Publisher: Wiley
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 ARS-AAOA, LLC
• Final Published Version (URL): http://dx.doi.org/10.1002/alr.21843
• Title of Journal or Parent Work: International Forum of Allergy and Rhinology
• ISSN: 2042-6976
• Volume: 7
• Issue: 1
• Start Page: 56
• End Page: 63
• Grant/Funding Information: Jeremiah A. Alt, Jess C. Mace, and Timothy L. Smith were supported for this investigation by a grant from the National Institute on Deafness and Other Communication Disorders (NIDCD), one of the National Institutes of Health, Bethesda, MD (R01 DC005805; PI/PD: TL Smith).; Public clinical trial registration number (www.clinicaltrials.gov) NCT01332136.
• Keywords: pain; Life Sciences & Biomedicine; MODAFINIL; SYMPTOM CLUSTER; DISABILITY; BREAST-CANCER; Science & Technology; depression; MODULATION; FATIGUE; chronic disease; QUALITY-OF-LIFE; sinusitis; outcome assessment; Otorhinolaryngology; DISTURBANCE; DOPAMINE SYSTEM; TRANSPORTERS; sleep
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Background: Depression, pain, and sleep disturbance is a symptom cluster often found in patients with chronic illness, exerting a large impact on quality of life (QOL). A wealth of literature exists demonstrating a significant association between depression, pain, and sleep dysfunction in other chronic diseases. This relationship has not been described in patients with chronic rhinosinusitis (CRS). Methods: Sixty-eight adult patients with CRS were prospectively enrolled. Patients at risk for depression were i dentified using the Patient Health Questionnaire-2 (PHQ-2) using a cut-off score of ≥1. Pain experience was measured using the Brief Pain Inventory Short Form (BPI-SF) and the Short Form McGill Pain Questionnaire (SF-MPQ). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Results: Forty-seven patients were at risk for depression. Significant positive correlations were found between total PSQI scores and all pain measures (R = 0.38-0.61, p ≤ 0.05) and between total PSQI scores and PHQ-2 scores (R = 0.46, p < 0.05). For patients at risk for depression, significant, positive correlations were found between pain measures, the total PSQI score, and the 3 PSQI subdomains (sleep latency, sleep quality, and daytime dysfunction; R = 0.31-0.61, p < 0.05). The relationship between pain and sleep dysfunction scores was not seen in the absence of depression. Conclusion: Depression, pain, and sleep dysfunction are interrelated in patients with CRS. In the absence of depression, significant correlations between pain and sleep are not observed, suggesting that depression plays a key role in this interaction. Further research is needed to investigate the complex relationship between depression, pain, and sleep dysfunction in CRS.