Chronic musculoskeletal pain (CMP) has an impact on sleep quality. Sleep disturbances contribute to the appearance of modifiable disorders (anxiety or depression) and reinforce the negative impact of pain. Restoring quality sleep could lead to better pain control. Our objective was to evaluate the efficacy of a sleep and circadian intervention program (SCIP) to improve the state of anxiety and depression in patients with CMP. Funding by CIBERES and the Spanish Sleep Society.

50 patients with CMP were recruited: 21 belonged to the SCIP group and 28 to the control group. In both groups, demographic data, medical history, analgesic consumption and different questionnaires were collected at baseline and at 6-month follow-up. The questionnaires assessed pain (NRS, EQ-5D-5L), quality of life (SF36, EQ-5D-5L) and anxiety and depression (HADS, PASS20). In the SCIP group, polysomnography and sleep questionnaires (Epworth, Pittsburgh, ISI, FOSQ) were performed. In those with sleep disorders, specific treatment was indicated. Generalized estimating equation models were used for statistical analysis.

The baseline comparison of SCIP vs. non-SCIP did not show significant differences in any of the clinical variables or in the questionnaires used, except in the usual activities of the EQ-5D (Table 1). We found an effect of the intervention with a statistically significant decrease in the level of anxiety measured by both PASS20 (-10.7 points; p=0.031) and HADS (-3.8 points; p=0.015) questionnaires (Table 2). No effect was observed on pain scale or on quality of life.

Treatment of sleep disorders in patients with CMP could reduce anxiety and depression levels and help improve pain control.