Prevalence and incidence of chronic neuropathic pain and its association with anxiety, depression, and sleep disturbances in brazilian head and neck cancer patients.

PURPOSE: This study aimed to determine the prevalence and incidence of chronic pain with neuropathic characteristics and to explore its association with psychological disorders and sleep disturbances in Brazilian patients with head and neck cancer.

METHODS

A cross-sectional, observational study was conducted with 82 patients undergoing treatment for head and neck cancer at two cancer centers. Patients were categorized based on the presence of chronic pain and assessed for pain type using the Visual Analog Scale and the Portuguese validated version of the Douleur Neuropathique 4 (DN4) questionnaire. Psychological and sleep parameters were evaluated using the Hospital Anxiety and Depression Scale and the Mini-Sleep Questionnaire. Patients without baseline chronic pain were followed up at 3 and 6 months to assess incident cases.

RESULTS

Chronic pain prevalence was 20.2%, with neuropathic features present in 47.1% of cases. Incidence of chronic pain at follow-up was 27.7%, with 11% showing neuropathic characteristics. Patients with metastasis (p = 0.014) and tumors in the oral cavity or neck (p = 0.006) had higher rates of chronic pain. Among patients without chronic pain, 27.7% developed it during follow-up, with 11% presenting neuropathic characteristics. Incident pain was significantly associated with elevated anxiety scores (p < 0.001). Worse sleep quality correlated positively with anxiety and depression levels (rs = 0.39; p = 0.001).

CONCLUSION

Pain with neuropathic characteristics was present in 47.1% of the patients with chronic pain and developed in 11% during follow-up. Chronic pain was also associated with poorer sleep quality and elevated anxiety levels.