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Poor sleep habits amplify knee pain

Patients with knee osteoarthritis with poor sleep habits display greater central sensitisation

Ingrid Torjesen

Tuesday, 09 June 2015

Patients with knee osteoarthritis (OA) who have poor sleep habits display greater central sensitisation, an amplification of clinical pain, findings of a study* published in Arthritis Care & Research show.

The findings also show that OA patients who catastrophise (are consumed by thoughts of pain) had increased central sensitisation that was associated with greater clinical pain.

Roughly one third of older adults have knee OA, a leading cause of pain and disability worldwide and researchers believe that central sensitisation, which is a hypersensitivity to pain, may contribute to the clinical pain amplification.

To confirm this, US researchers categorised 208 patients into four groups: OA patients with insomnia, OA patients with normal sleep habits, healthy controls with insomnia, and healthy controls without a pain syndrome and normal sleep. Patients then completed sleep assessments, psychological and pain evaluations, and sensory testing.

The results showed that patients with knee OA and insomnia had the greatest degree of central sensitisation compared to the controls. Poor sleep and high catastrophising scores increased levels of central sensitisation. In turn, central sensitisation was significantly associated with increased clinical pain.

Lead author Claudia Campbell, from the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine in Baltimore, Maryland, said: “Our study is the largest and most comprehensive examination of the relationship between sleep disturbance, catastrophising and central sensitisation in knee OA.”

Commenting on its findings, she said: “While no causal processes may be determined from this study, our data suggest that those with low sleep efficiency and higher catastrophising have the greatest central sensitisation. Understanding the intricate relationship between sleep, central sensitisation, and catastrophising has important clinical implications for treating those with chronic pain conditions such as knee OA.”

* Claudia M. Campbell, et al. Sleep, pain catastrophizing and central sensitization in knee osteoarthritis patients with and without insomnia. Arthritis Care & Research, 2015. DOI: 10.1002/acr.22609

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