Affiliation:
1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine , Baltimore, MD 21224, United States
2. Edson College of Nursing and Health Innovation, Arizona State University , Phoenix, AZ 85004, United States
3. Harvard Medical School , Boston, MA 02115, United States
Abstract
Abstract
Objective
Up to 40% of individuals who undergo total knee arthroplasty (TKA) experience some degree of pain following surgery. Presurgical insomnia has been identified as a predictor of postsurgical pain; however, modifiable presurgical behaviors related to insomnia have received minimal attention. The objective of the present study was to develop a 2-item sleep and pain behavior scale (SP2) to investigate a maladaptive sleep and pain behavior and is a secondary analysis of a larger, parent study.
Methods
Patients (N = 109) completed SP2 at baseline and 12 months and questionnaires assessing sleep and pain at baseline (pre-TKA), 6 weeks, 3, 6, and 12 months post-TKA. SP2 demonstrated adequate preliminary psychometric properties.
Results
As hypothesized, even after controlling for baseline insomnia, pain, anxiety and other covariates, baseline SP2 predicted insomnia symptom severity at 6 weeks (β = 2.828), 3 (β = 2.140), 6 (β = 2.962), and 12 months (β = 1.835) and pain at 6 weeks (β = 6.722), 3 (β = 5.536), and 6 months (β = 7.677) post-TKA (P < .05). Insomnia symptoms at 6-weeks post-TKA mediated the effect of presurgical SP2 on pain at 3 (95% CI: 0.024–7.054), 6 (95%CI: 0.495–5.243), and 12 months (95% CI: 0.077–2.684).
Conclusions
This provides preliminary evidence that patients who cope with pain by retiring to their bed and bedroom have higher rates of post-surgical insomnia and pain and supports efforts to target this maladaptive sleep and pain behavior to reduce postsurgical pain.
Funder
National Institutes of Health
Publisher
Oxford University Press (OUP)
Subject
Anesthesiology and Pain Medicine,Neurology (clinical),General Medicine
Cited by
1 articles.
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