Insomnia, Musculoskeletal Pain
Conditions
Brief summary
The main purpose of this project is to conduct a prospective cohort study in order to better understand the importance of insomnia symptoms in patients referred to interdisciplinary rehabilitation due to chronic pain. Moreover, this project will also raise awareness on how insomnia symptoms, alone, and in interplay with factors such as function, psychological distress, physical activity, and fatigue impact on patient's prognosis and work ability. Our aim is that this knowledge can be used to design new interventions and improve rehabilitation programs for this patient group.
Detailed description
Insomnia is a vast problem among patients with chronic musculoskeletal pain. Despite the close relation between pain and sleep, sleep quality has received little attention in rehabilitation programs for patients with pain. So far, there is a lack of studies investigating the association between insomnia and chronic pain in patients referred to interdisciplinary rehabilitation. Identifying subgroups of the population with higher burden of poor sleep will aid clinicians to tailor treatment and prevention strategies. Moreover, knowledge on how insomnia symptoms fluctuate throughout the rehabilitation program and how insomnia symptoms interact with factors such as mental distress, physical activity, and fatigue impact on patient's recovery (e.g., the prognosis of pain, quality of life, and work participation) can be used to develop and implement more successful rehabilitation programs. This is a cohort study primarily designed to address sleep problems in patients referred for pain rehabilitation by using questionnaire data from the rehabilitation centers linked to registry data. This study will constitute both a cross-sectional survey among patients referred to rehabilitation before they participate in rehabilitation. In addition to questionnaires, administrative data and clinical data, these data will be linked to national health registries on prescriptions, health care use and sickness absence. Potential participants are patients referred to rehabilitation at five different Unicare rehabilitation centers in Norway (Unicare Helsefort, Unicare Coperio, Unicare Hokksund, Unicare Friskvern and Unicare Jeløy) due to long-term pain complaints.
Interventions
BEHAVIORALInpatient rehabilitation
Inpatient multimodal rehabilitation in specialist health care
BEHAVIORALOutpatient day rehabilitation
Multimodal rehabilitation in specialist health care with program lasting whole work days
Sponsors
Unicare
Norwegian University of Science and Technology
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Take part in rehabilitation for long-term pain complaints at one of the five centers * Consented to research
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Insomnia | Baseline | Measured by Insomnia severity index (ISI) |
| Pain intensity | Baseline | Measured by visual analogue scale (0 to 100 scale) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Health-related quality of life | Baseline | Measured by the the 5-level EQ-5D version (EQ-5D-5L) questionnaire. The index value range ranges from -0.285 to 1, where lower values indicate poorer health-related quality of life. |
| Fatigue | Baseline | Measured using a visual analogue scale from 0 to 100 |
| Function | Baseline | Measured by the patient-specific functional scale (PSFS) |
| Sickness absence | Up to five years before rehabilitation and one year after rehabilitation | Use of medical benefits based on registry data |
| Workability | Baseline | Measured by the workability index single item (self- assessed work ability on a 0-10 scale) |
| Symptoms of anxiety and depression | Baseline | Measured by the Hopkins Symptom Checklist-25 (HSCL-25), mean score calculated (1-4) |
| Prescriptions | Up to five years before rehabilitation and one year after rehabilitation | Use of sleep psychotropic medications, and pain medications based on registry data |
| Physical activity | Baseline | Measured by questions from the HUNT study |
| Health care use | Up to five years before rehabilitation and one year after rehabilitation | Health care use in primary care based on registry data |
Countries
Norway
Outcome results
None listed