Estudo do binômio insônia-dor musculoesquelética crônica na pós-menopausa

• Ano de defesa: 2017
• Autor(a) principal: Frange, Cristina Mattos Pereira [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Sleep; Insomnia; Chronic musculoskeletal pain; Climacteric symptoms; Postmenopause; Quality of life; Sono; Insônia; Dor muculoesquelética crônica; Climatério; Pós-Menopausa; Qualidade de vida; Sinais e sintomas
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5225342; http://repositorio.unifesp.br/handle/11600/50422

Sleep and pain are assumed to share a reciprocal relationship. Chronic musculoskeletal pain, and sleep disorders such as insomnia are two central symptoms of menopause symptomatology. Although postmenopausal women often suffer from both, there is a lack of studies addressing these two factors and their interaction. The objectives of this study were therefore to investigate the relationship between these two factors and their effect on sleep quality and pattern; chronic musculoskeletal pain severity, intensity and interference in daily function, the number of pain sites; menopausal and mood symptoms; and quality of life. We examined this relationship between sleep and chronic musculoskeletal pain, through a 10-day temporal analysis. Our sample was composed of 4 groups: CTRL - control group, absence of diagnosis of insomnia and musculoskeletal pain; CMP Group - absence of insomnia and complaint of chronic musculoskeletal pain; INS Group - clinical diagnosis of insomnia and absence of chronic musculoskeletal pain and CMP+INS Group - clinical diagnosis of insomnia and presence of complaint of chronic musculoskeletal pain. We performed two analyzes: coss sectional and microlongitudinal. All volunteers answered questionnaires about pain, quality of sleep and life, climacteric, anxiety and depression symptoms, and blood samples were collected for confirmation of postmenopausal status, and we performed polysomnography and actigraphy exams. Our results indicate that insomnia by itself was associated with more self-reported pain. The presence of chronic musculoskeletal pain alone does not modify sleep, either subjectively or objectively. However, the association of both comorbidities was related to worsening menopausal and anxiety symptoms, higher sleep fragmentation, worse severity of chronic musculoskeletal pain, as well as more interference in daily activities and more pain sites, and also lower quality of life. Our findings indicated that the higher the sleep duration, the higher the pain intensity upon waking, while increased pain at bedtime predicted longer sleep duration and also time in bed in postmenopausal women. These results strongly suggest that sleep and pain conditions should both be targeted in the treatment of postmenopausal women in order to improve quality of life and reduce the possible development of comorbidities, such as anxiety and depression.