Relationship between sleep disturbance, pain, depression and functioning in long-term sick-
listed patients experiencing difficulty in resuming work
Sammanfattning
OBJECTIVE: To describe the frequency of reported sleeping, depression and pain problems, the
severity of these problems and the degree of self-estimated difficulties in mental functions and
activities in relation to the sleep disturbance and pain category group in patients on long-term sick-
leave.
DESIGN: Cross-sectional study.
Patients: A total of 1206 patients experiencing difficulty in resuming work.
METHODS: Patient examinations by specialists in psychiatry, orthopaedic surgery and rehabilitation
medicine. Validated questionnaires, including status regarding depression, sleep, pain and
functioning were used.
RESULTS: The prevalence of sleep disturbance was 83%; 74% of the patients with moderate/severe
sleep disturbance also had moderate/severe pain problems and 26% had no/mild pain problems.
Fifty-seven percent of the patients with no/mild sleep disturbance and 83% of the patients with
moderate/
severe sleep disturbance also had depression. The degree of difficulty in performing the 6 selected
International Classification of Functioning, Disability and Health activities and mental functions was
higher for the category with moderate/severe sleep problems, compared with those with no/mild
sleep problems.
CONCLUSION: To optimize rehabilitation for patients on long-term sick-leave experiencing difficulties
in returning to work, the results indicate a need also to focus attention on sleep problems and not
only on pain and depression. This may entail the planning of measures to improve decision-making
and concentration and alleviate lassitude, fatigability, sadness and pessimistic thoughts.