In a primary care population of 327 older adults (age 60+) with chronic osteoarthritis (OA) pain and insomnia, we examined the relationship between short-term improvement in sleep or pain and long-term sleep, pain, depression, and fatigue by secondary analyses of randomized controlled trial data. Study participants, regardless of trial arm, were classified as Sleep or Pain Improvers with ≥30% baseline to 2-month reduction on the Insomnia Severity Index or the Brief Pain Inventory, respectively, or Sleep or Pain Non-Improvers. After controlling for trial arm and potential confounders, both Sleep and Pain Improvers showed significant (p < .01) sustained improvements across 12 months compared to respective Non-Improvers for the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index, Brief Pain Inventory-short form (total, Interference, and Severity subscales), Patient Health Questionnaire, and Flinders Fatigue Scale. The effect sizes (Cohen’s f2) for the sustained benefits in both Sleep and Pain Improvers compared to their respective Non-Improvers for all variables were small (<0.15) with the exception of medium effect size for sustained reduction in insomnia symptoms for the Sleep Improvers. We conclude that short-term sleep improvements in pain populations with comorbid insomnia precede benefits not only for long-term improvement in sleep but also for reduced pain over the long-term, along with associated improvements in depression and fatigue. Short-term improvements in pain appear to have similar long-term sequelae. Successfully improving sleep in pain populations with comorbid insomnia may have the additional benefits of improving both short- and long-term pain, depression, and fatigue. Trial Registration: OsteoArthritis and Therapy for Sleep (OATS) NCT02946957: https://clinicaltrials.gov/ct2/show/NCT02946957.

中文翻译：

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长期改善患有骨关​​节炎疼痛和失眠的老年人的睡眠、疼痛、抑郁和疲劳

在 327 名患有慢性骨关节炎 (OA) 疼痛和失眠的老年人（60 岁以上）的初级保健人群中，我们通过以下方法检查了睡眠或疼痛的短期改善与长期睡眠、疼痛、抑郁和疲劳之间的关系随机对照试验数据的二次分析。研究参与者，无论试验组如何，都被归类为睡眠或疼痛改善者，在失眠严重程度指数或简要疼痛清单上分别降低 ≥ 30% 基线至 2 个月，或睡眠或疼痛非改善者。在控制试验组和潜在混杂因素后，睡眠和疼痛改善剂在 12 个月内均显示出显着 (p < .01) 的持续改善，与失眠严重度指数 (ISI)、匹兹堡睡眠质量指数、短暂疼痛的相应非改善剂相比库存短格式（总计、干扰、和严重程度分量表）、患者健康问卷和弗林德斯疲劳量表。与它们各自的非改善者相比，所有变量的睡眠和疼痛改善者的持续益处的效果大小 (Cohen's f2) 都很小 (<0.15)，但睡眠中失眠症状持续减少的中等效果大小除外改良剂。我们得出结论，在伴有失眠症的疼痛人群中，短期睡眠改善不仅对长期睡眠改善有益，而且对长期减轻疼痛以及抑郁和疲劳的相关改善都有好处。疼痛的短期改善似乎有类似的长期后遗症。成功改善伴有失眠症的疼痛人群的睡眠可能具有改善短期和长期疼痛的额外好处，抑郁和疲劳。试验注册：骨关节炎和睡眠疗法 (OATS) NCT02946957：https://clinicaltrials.gov/ct2/show/NCT02946957。