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Knee OA: Poor Sleep, Negative Attitude Worsen Pain

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Knee osteoarthritis (OA) patients are more likely to experience intense pain if they have poor sleep habits and a negative attitude, according to a US study.

Researchers found that patients with insomnia and those who “catastrophise” — are consumed by thoughts of pain — had increased central sensitisation, or hypersensitivity to pain.

The research, led by Johns Hopkins University in Baltimore, involved 208 participants who were categorised into four groups: OA patients with insomnia, OA patients with normal sleep habits, healthy controls with insomnia, and healthy controls without a pain syndrome and normal sleep. All participants completed sleep assessments, psychological and pain evaluations, and sensory testing.

Results published in the medical journal Arthritis Care & Research show that patients with knee OA and insomnia had the greatest degree of central sensitisation compared to the controls.

Among all subjects involved in the study, those with poor sleep and high catastrophising scores reported increased levels of central sensitisation and this, in turn, was significantly associated with increased clinical pain.

“Understanding the intricate relationship between sleep, central sensitisation and catastrophising has important clinical implications for treating those with chronic pain conditions such as knee OA,” commented lead author Dr. Claudia Campbell from the Department of Psychiatry & Behavioral Sciences at Johns Hopkins University School of Medicine.

This was the largest and most comprehensive examination of the relationship between sleep disturbance, catastrophising and central sensitisation in knee osteoarthritis, Dr. Campbell said.