Sleep impairment in patients with painful diabetic peripheral neuropathy

Clin J Pain. 2006 Oct;22(8):681-5. doi: 10.1097/01.ajp.0000210910.49923.09.


Objective: This study evaluated sleep impairment associated with painful diabetic peripheral neuropathy (DPN), a neuropathic pain condition. Sleep is of critical concern for DPN because sleep impairment and its comorbidities may influence type 2 diabetes progression.

Methods: This is a supplemental analysis of sleep data from a burden of illness study of patients with painful DPN (N=255, 61+/-12.8 y old, 51.4% women). Sleep was evaluated using the Medical Outcomes Study Sleep measure (MOS-Sleep). MOS-Sleep scores were compared with general population norms (N=1011), the MOS chronic disease sample (N=3445), and patients with postherpetic neuralgia (N=89). The MOS-Sleep Sleep Adequacy score was compared with data from the MOS diabetes subsample (N=590).

Results: Patients with painful DPN reported impaired sleep relative to the general population (P<0.001), the chronic disease sample (P<0.001), and postherpetic neuralgia patients (P<0.05). Self-rated MOS-Sleep Sleep Adequacy was significantly less for the painful DPN than for the diabetes sample (P<0.001), although self-reported hours of sleep were not significantly different. Multiple regression indicated that age, average daily pain, and anxiety and depression symptom levels were each significantly (P<0.01) associated with, and collectively accounted for, 47% of variance in the MOS-Sleep Sleep Problems Index.

Discussion: Painful DPN is associated with considerable sleep impairment. Given the recognized association between sleep impairment, type 2 diabetes and metabolic and affective disturbance, and the known adverse impact of affective disturbance on diabetes self-care, addressing these features-pain, sleep, and affective disturbance-is an important aspect of care for patients with painful DPN.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Comorbidity
  • Diabetic Neuropathies / diagnosis*
  • Diabetic Neuropathies / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnosis*
  • Pain / epidemiology*
  • Prevalence
  • Risk Assessment / methods*
  • Risk Factors
  • Sleep Wake Disorders / diagnosis*
  • Sleep Wake Disorders / epidemiology*
  • United States / epidemiology