The relationships between pain severity, hyperarousal, insomnia, daytime sleepiness, and depression were explored in a sample of 41 adults with chronic pain and sleep disruption. Participants were recruited from medical clinics and non-medical establishments using flyers posted in designated areas, as well as through Craigslist advertisements, emails sent to listservs and snowball sampling. A correlational analysis was conducted and significant, positive relationships were found between chronic pain and insomnia (r = .458, p = .003), insomnia and daytime sleepiness (r = .496, p = .001), insomnia and depression (r = .314, p < .046) and hyperarousal and depression (r = .447, p = .003). These correlations support the literature that describes chronic pain and insomnia and depression and insomnia as comorbid conditions. However, the significant, positive relationship found between insomnia and daytime sleepiness was counter to what was hypothesized that a significant, negative relationship would exist between insomnia and daytime sleepiness. Insomnia and chronic pain are associated with hyperarousal (or prolonged activation of the central and sympathetic nervous systems), causing some people with these conditions to not feel abnormally sleepy during the day despite sleep deprivation. This significant correlation may be explained by the findings that some people with insomnia subjectively rate their daytime sleepiness more intense than what is actually found on objective tests of sleep latency, such as the MSLT. These findings suggest that future investigators should include an objective test of sleep latency when measuring daytime sleepiness and treat pain, insomnia, hyperarousal, daytime sleepiness, and depression collectively.
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