Sleep Disturbances Linked to Pain and Depression Among Patients with Osteoarthritis

Researchers confirm a strong association between sleep disturbances and pain and depression among patients with osteoarthritis.

Arthritis is listed as one of the top three health concerns that trigger disability in the U.S. One of the common form of arthritis is osteoarthritis (OA) and it is estimated that this condition affects 30 million people in the U.S. alone. This degenerative joint disease, often called as the wear-and-tear arthritis, causes pain, swelling and reduced motion in the joints.

Several peer-reviewed studies have shown that osteoarthritis pain is linked with elevated risk of depressive symptoms due to its effect on fatigue and disability. It was also shown that knee OA was linked with issues that include initiating sleep (31 percent), difficulty in maintaining sleep at night (81 percent) and general sleep problems (77 percent).

Researchers at the University of Alabama confirm that among osteoarthritis patients, sleep disturbances are linked to pain and depression and not disability. They observed that poor sleep ups depression and disability but does not worsen pain over a period of time.

"Sleep disturbance is a common complaint among those with pain, particularly among those with OA," explains Dr. Patricia Parmelee from the Center for Mental Health & Aging at The University of Alabama in Tuscaloosa. "Our research is unique as we investigate the complex relationships among sleep, OA-related pain, disability and depressed mood simultaneously in a single study."

In the current study, the researchers gathered details of sleep disturbances, pain, functional limitations and depressive symptoms from 288 patients with knee OA. Patients were selected from various settings to get a broad representation of OA subjects. Sleep disturbances at the beginning of the study were used to calculate the changes in pain, disability and depression after a one-year period.

On analyzing the data they noticed that sleep was independently linked with pain and depression at baseline. However, there was no association between disability and baseline sleep disturbances. In those with high level pain, improper sleep and pain together intensified depression. Sleep disturbances at baseline elevated depression and disability but not pain at one-year follow up.

Dr. Parmelee says, "This study shows that depression plays a strong role in the sleep-pain connection, particularly with severe pain. Further investigation of sleep in disability progression may lead to new interventions that disrupt the cycle of OA distress."

The finding was documented in the journal of American College of Rheumatology - "Arthritis Care & Research".