Sleep disturbance in individuals with physical disabilities and chronic pain: The role of physical, emotional and cognitive factors.

BACKGROUND: Sleep problems are common for individuals living with physical disabilities and chronic pain. However, the factors that influence the relationship between pain and sleep problems in these populations remain unknown.

OBJECTIVE: The aim of this study was to increase our understanding of the physical, emotional and cognitive factors associated with sleep disturbance in individuals with chronic health conditions often associated with physical disabilities.

METHODS: Participants were recruited from a database of individuals with a variety of chronic health conditions, including multiple sclerosis, spinal cord injury, back pain, osteoarthritis, and amputations. To participate in the study, they needed to report having a chronic pain problem. Participants completed an online survey using REDCap assessing average pain intensity (Numerical Rating Scale-11), pain extent (number of painful body areas), sleep disturbance (PROMIS Sleep Disturbance), depression (PROMIS Emotional Distress-Depression) and catastrophizing (Coping Strategies Questionnaire). A total of 455 participants (Mage = 58.9; SD = 11.4), of which 292 (64%) were women, provided complete data. We performed a series of four regression analyses.

RESULTS: After controlling for age and sex, the predictors explained an additional 7-16% of the variance in sleep disturbance. The final model with all of the predictors explained 22%.

CONCLUSIONS: Consistent with the study hypothesis, all the variables examined made significant and independent contributions to the variance in sleep disturbance. The findings provide additional evidence that physical, emotional and cognitive factors all play a role in the sleep quality of individuals with chronic health conditions often associated with physical disabilities.