Chapter 27 - Impact of chronic pain upon anxiety, sleep, and mood dimensions

Summary

This chapter describes the influence of sleep disorders, depression, and anxiety conditions upon patients with chronic pain. Sleep disturbances may occur prior to, during, or following the diagnosis of the chronic pain condition. The main goal of treatment should always be patients' overall well-being. While some agents used for pain treatment promotes sleep, including tricyclic antidepressants, other agents may worsen or even contribute to sleep issues, such as opioids or NSAIDs. Besides just sleep disruption, the presence of both anxiety and depression are often coexisting, providing additive effects upon general functioning. Assessment of these comorbid disorders must be a routine component of the clinical evaluation, and the same treatment considerations also apply to these comorbid disorders and selection of reasonable therapies to manage all comorbidities in tandem as possible. The treatment of pain without recognition of these comorbidities is often a dead end and can be analogous to wearing blinders.