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Spinal cord stimulation ‘could help chronic pain and sleep issues’

Research demonstrates improvements in both conditions in individuals where they are linked

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Spinal cord stimulation could support people who are experiencing disturbed sleep as a result of chronic pain, new research has revealed. 

Chronic pain and sleep are thought to be correlated, with about 65 million people in the United States affected by chronic pain and up to 88 per cent also experiencing poor quality sleep. 

Medics believe that sleep disorders may exacerbate pain by contributing to the risk of obesity, diabetes and depression. 

Now, a research project has looked at the impact of spinal stimulation as a means to tackle both issues, following mounting anecdotal evidence that it improves aspects of sleep as well as helping to treat a multitude of chronic pain conditions. 

The study, by Florida Atlantic University’s Schmidt College of Medicine, in collaboration with Albany Medical Center, successfully established minimally clinical important difference ranges for the insomnia severity index outcome measure to help gauge improvement in insomnia after spinal cord stimulation.

Results showed insomnia severity index improvement of 30 per cent or more in 39.1 per cent of the participants, and an Epworth sleepiness scale of 30 per cent or more in 28.1 per cent of the participants.

Additionally, minimally clinical important difference values of 2.4 to 2.6 correlated with improvement in disability and depression in the participants.

“The physiologic mechanisms of both pain and sleep are complex, and the relationship between the two is poorly understood,” said Dr Julie Pilitsis, senior author and dean and vice president for medical affairs, FAU Schmidt College of Medicine. 

“By recognising the intersection of sleep disorders and chronic pain, treatment plans can be more focused and can thus lead to drastic improvements in overall health, beyond the improvement in sleep or pain alone.”

Researchers examined the relationship between pain outcome measures using the insomnia severity index, a clinical screening tool that assesses the severity of both nighttime and daytime components of insomnia. 

With this tool, they established the minimally clinical important difference – the smallest noticeable change that a patient perceives as clinically significant, and which could indicate a change in their management. 

Minimally clinical important difference is particularly useful in evaluating newer treatments, as these have a smaller cohort with which to compare for statistical significance.

“Our study includes pertinent sleep conditions in our analysis, as the interplay between sleep and chronic pain is important to consider in patients undergoing spinal cord stimulation,” said Dr Pilitsis. 

“As more studies are conducted on minimally clinical important difference thresholds, assessing the clinical response to spinal cord stimulation will improve. As such, we can gain a better understanding of the type of patient most likely to benefit from this treatment.”

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