Understanding the sleep-pain relationship in patients with interstitial cystitis/bladder pain syndrome.

Kelly AA, Jones K, Pineau O, Nickel JC, Rose J, Moldwin R, Doiron C, Riedl C, Cervigni M, Wyndaele J, Tripp A
Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024 · doi:10.5489/cuaj.8686 · PMID:38381928 · PMC11230695
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This study examined patients with interstitial cystitis/bladder pain syndrome and found that depressive symptoms and pain catastrophizing mediated the relationship between sleep disturbance and pain severity.

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This online study investigated the mechanisms linking sleep disturbance to pain severity in 74 patients diagnosed with interstitial cystitis/bladder pain syndrome using self-reported questionnaires. The researchers employed multiple and serial mediation models to assess the roles of depressive symptoms, pain catastrophizing, and resilience in this relationship. Results indicated that greater sleep disturbances were associated with increased pain severity primarily through elevated depressive symptoms and pain catastrophizing, rather than through resilience. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

IntroductionInterstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic pelvic pain condition with critical symptoms of urinary urgency and frequency, persistent bladder-related pain, and reduced quality of life. Poor-quality sleep can lead to significant disturbances in daily life and increased pain in IC/BPS patients. Resilience, depressive symptoms, and pain catastrophizing have univariate associations with sleep and pain in IC/BPS, suggesting they may be mechanisms in this sleep and pain relationship.MethodsThis online study recruited patients self-reporting a diagnosis of IC/BPS through support groups, social media posts (Facebook, Reddit, and Instagram), and urology clinic advertisements. Participants completed questionnaires on demographics, urologic symptoms, pain, pain catastrophizing, depressive symptoms, and resilience. Only those participants who met the RAND Interstitial Cystitis Epidemiology (RICE) criteria for IC/BPS diagnosis were included. A multiple mediation model was first examined, followed by a serial mediation model.ResultsSeventy-four participants (Mage= 47.0, standard deviation [SD ] 16.7, range 18-83 years) met inclusion criteria. A multiple mediation model showed greater sleep disturbance was associated with greater pain severity through depressive symptoms and pain catastrophizing, but not resilience (b=0.79, bootSE =0.26, bootCI [0.33, 1.35]). A serial mediation showed that the sleep-to-pain relationship had a significant indirect effect through pain catastrophizing and depressive symptoms (b=0.78, bootSE =0.26, bootCI [0.35, 1.32]).ConclusionsFindings suggest depressive symptoms and pain catastrophizing may be important psychosocial mechanisms in the sleep-to-pain relationship. These results help guide future sleep and pain research in IC/BPS and aid in developing and refining treatments.
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Introduction

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic pelvic pain condition with critical symptoms of urinary urgency and frequency, persistent bladder-related pain, and reduced quality of life. Poor-quality sleep can lead to significant disturbances in daily life and increased pain in IC/BPS patients. Resilience, depressive symptoms, and pain catastrophizing have univariate associations with sleep and pain in IC/BPS, suggesting they may be mechanisms in this sleep and pain relationship.

Methods

This online study recruited patients self-reporting a diagnosis of IC/BPS through support groups, social media posts (Facebook, Reddit, and Instagram), and urology clinic advertisements. Participants completed questionnaires on demographics, urologic symptoms, pain, pain catastrophizing, depressive symptoms, and resilience. Only those participants who met the RAND Interstitial Cystitis Epidemiology (RICE) criteria for IC/BPS diagnosis were included. A multiple mediation model was first examined, followed by a serial mediation model.

Results

Seventy-four participants (Mage= 47.0, standard deviation [SD] 16.7, range 18–83 years) met inclusion criteria. A multiple mediation model showed greater sleep disturbance was associated with greater pain severity through depressive symptoms and pain catastrophizing, but not resilience (b=0.79, bootSE=0.26, bootCI [0.33, 1.35]). A serial mediation showed that the sleep-to-pain relationship had a significant indirect effect through pain catastrophizing and depressive symptoms (b=0.78, bootSE=0.26, bootCI [0.35, 1.32]).

Conclusions

Findings suggest depressive symptoms and pain catastrophizing may be important psychosocial mechanisms in the sleep-to-pain relationship. These results help guide future sleep and pain research in IC/BPS and aid in developing and refining treatments. Downloads Downloads Published How to Cite Issue Section License You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA: - Post the Article on any Web site - Translate or authorize a translation of the Article - Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so - Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so. The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request. You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article. The CUA also requires you to warrant the following: - That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party; - That all individuals who have made a substantive contribution to the article are acknowledged; - That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and - That the Article does not libel or violate the privacy rights of any third party.

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