The unhappy triad: Pain, sleep complaints, and internalizing symptoms

Erin Koffel; Erin E Krebs; Paul A Arbisi; Christopher R Erbes; Melissa A Polusny

doi:10.1177/2167702615579342

The unhappy triad: Pain, sleep complaints, and internalizing symptoms

Erin Koffel, Erin E Krebs, Paul A Arbisi, Christopher R Erbes, Melissa A Polusny

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

There is limited understanding of the etiology and temporal relations of chronic pain, sleep complaints, and depression/ anxiety. Several models have been proposed by which sleep disruption represents a common mechanism for the comorbidity of these symptoms. The goals of this study were to (a) clarify the boundaries of these domains and (b) examine the relations of these symptoms over time following exposure to stressful and potentially traumatic experiences during a combat deployment. We found support for three distinct domains of sleep complaints, internalizing symptoms, and physical complaints. We tested two competing models that have been proposed in the literature, controlling for negative and positive emotionality. Internalizing symptoms strongly mediated the relation between sleep complaints and pain (total effect = .15, direct effect = –.05). The study suggests that increases in sleep complaints immediately following deployment increase the risk of internalizing symptoms and pain several years after deployment.

Original language	English (US)
Pages (from-to)	96-106
Number of pages	11
Journal	Clinical Psychological Science
Volume	4
Issue number	1
DOIs	https://doi.org/10.1177/2167702615579342
State	Published - Jan 1 2016

Bibliographical note

Funding Information:
This research was supported by grants to Melissa A. Polusny from the Minnesota Medical Foundation (Grant 3662-9227-06) and Department of Defense Congressionally Directed Medical Research Program (W81XWH-07-2-0033), a grant to Christopher R. Erbes from the Department of Veterans Affairs Health Services Research and Development (RRP 08-385), as well as a grant to Paul A. Arbisi from the University of Minnesota Press. This material is the result of work supported with resources and the use of facilities at the Minneapolis VA Health Care System, Minneapolis, MN. The views expressed in this article are those of the authors and do not reflect the official policy or position of the U.S. Department of Veterans Affairs.

Publisher Copyright:
© The Author(s) 2015.

Keywords

Chronic pain
Insomnia
Internalizing disorders
Lassitude

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abstract = "There is limited understanding of the etiology and temporal relations of chronic pain, sleep complaints, and depression/ anxiety. Several models have been proposed by which sleep disruption represents a common mechanism for the comorbidity of these symptoms. The goals of this study were to (a) clarify the boundaries of these domains and (b) examine the relations of these symptoms over time following exposure to stressful and potentially traumatic experiences during a combat deployment. We found support for three distinct domains of sleep complaints, internalizing symptoms, and physical complaints. We tested two competing models that have been proposed in the literature, controlling for negative and positive emotionality. Internalizing symptoms strongly mediated the relation between sleep complaints and pain (total effect = .15, direct effect = –.05). The study suggests that increases in sleep complaints immediately following deployment increase the risk of internalizing symptoms and pain several years after deployment.",

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The unhappy triad: Pain, sleep complaints, and internalizing symptoms

Abstract

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