In the present issue of the Scandinavian Journal of Pain, Dragioti and co-authors report on the factor structure and psychometric properties of the 7-Item Insomnia Severity Index (ISI) with patients of a pain clinic . They suggest that an even shorter 4-item version of the Insomnia Severity Index could effectively evaluate insomnia in chronic pain patients.1The reciprocal association between pain and insomniaThe association between pain and sleep disorders has been established [2, 3, 4]. A systematic review some years ago revealed clearly that chronic low back pain was associated with several aspects of sleep quality during the preceding night . The review could not conclude that impaired sleep affects low back pain. However, a recent study with chronic low back pain patients showed that in addition to pain affecting sleep quality, higher pain intensity was predicted by difficulty in falling asleep, waking after sleep onset and low sleep efficiency .This year a study was published which was based on combined data from a controlled clinical trial dealing with musculoskeletal pain. It showed that changes in reported sleeping difficulties three months from the baseline predicted a change in pain 12 months from the baseline . A reverse association, although weaker,
Scandinavian Journal of Pain – de Gruyter
Published: Oct 1, 2015
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