Chronic pain and sleep problems frequently co-occur. Pain itself disturbs sleep, but other factors may also contribute to sleep problems in pain patients. This cross-sectional study of 473 patients (69.9% female, mean age 47 years) entering tertiary pain management compared normally sleeping pain patients with those having recurring sleep problems to determine the relationship between pain and sleep. Groups were compared for pain and pain aetiology, pain-related anxiety, childhood adversities, use of sleep and pain medications, self-reported diseases, and sleep disorders. Furthermore, the association of pain-related anxiety (cognitive anxiety, escape/avoidance, fear, and physiological anxiety) with more disturbing sleep problems was investigated in the whole cohort. The main results were that those with sleep problems more often reported multiple health conditions than those sleeping normally (depression 31.6% vs 5.0%; angina pectoris 6.5% vs 0.0%; asthma 19.6% vs 1.7%; low back problems 55.1% vs 23.3%; joint disease other than rheumatoid arthritis 32.3% vs 18.3%). Accumulations of 5 or more childhood adversities were more often present in those with sleep problems. Restless legs symptoms were more common in those with sleep problems than those sleeping normally (33.2% vs 11.7%). Patients having sleep problems reported more use of sleep and pain medications than those sleeping normally. Findings about pain-related anxiety suggest physiological reactions as significant factors for increased sleep disturbances. These factors need to be addressed in the management of the comorbidity of pain and sleep problems, and research to understand mechanisms in these is sorely needed.

慢性疼痛和睡眠问题经常同时发生。疼痛本身会干扰睡眠，但其他因素也可能导致疼痛患者的睡眠问题。这项横断面研究纳入了 473 名进入三级疼痛管理的患者（69.9% 为女性，平均年龄 47 岁），将正常睡眠疼痛患者与反复出现睡眠问题的患者进行比较，以确定疼痛与睡眠之间的关系。比较各组的疼痛和疼痛病因、与疼痛相关的焦虑、童年逆境、睡眠和止痛药物的使用、自我报告的疾病和睡眠障碍。此外，在整个队列中研究了与疼痛相关的焦虑（认知焦虑、逃避/回避、恐惧和生理焦虑）与更令人不安的睡眠问题的关联。主要结果是，有睡眠问题的人比睡眠正常的人更常报告多种健康问题（抑郁症 31.6% vs 5.0%；心绞痛 6.5% vs 0.0%；哮喘 19.6% vs 1.7%；腰部问题 55.1% vs 23.3%） ; 类风湿性关节炎以外的关节疾病 32.3% vs 18.3%)。有睡眠问题的人更容易出现 5 种或更多童年逆境的累积。不宁腿症状在有睡眠问题的人中比在正常睡眠的人中更常见（33.2% vs 11.7%）。有睡眠问题的患者报告比睡眠正常的患者更多地使用睡眠和止痛药物。关于与疼痛相关的焦虑的研究结果表明，生理反应是导致睡眠障碍增加的重要因素。在治疗疼痛和睡眠问题的共病时需要解决这些因素，并且迫切需要研究了解这些因素的机制。