Objective:

To measure cross-sectionally sleep and quality of life perception in Distal Symmetric Polyneuropathy (DSP) participants with moderate to severe pain versus participants with none or mild pain.

Background:

Painful DSP is associated with reports of sleep impairment with worse pain perception affecting quality of life.

Design/Methods:

Participants with DSP were administered questionnaires including Pittsburgh Sleep Quality Index(PSQI), Insomnia Severity Index(ISI), Epworth Sleepiness Scale(ESS), and NeuroQoLs. DSP diagnoses were confirmed by neurologists. Painful DSP was defined based on reporting moderate to severe pain (pain severity score > 4) on the Brief Pain Inventory (BPI) short form. Non-painful DSP was defined as none or mild pain (pain severity score < 4) on the BPI.

Results:

42.9% of participants were female (21/49) with a median 66±12.9 years. Median BMI was 26.2 ± 6.1kg/m². The prevalence of painful DSP was 14/49 (28.6%). Mean ISI scores were significantly greater for the painful group (16.0 ± 8.18, moderate insomnia) compared to the non-painful group (7.37 ± 5.99, subthreshold insomnia ; p=0.0002), as were PSQI scores (9.93 ± 5.27 vs 6.63 ± 4.12; p=0.0239). However ESS scores were not significantly different between the two groups (8.36 ± 5.73 vs 5.86 ± 4.71; p=0.1216). Participants with painful neuropathy also had worse NeuroQoL sleep (62.2 vs 47.4; p<0.001), fatigue (53.8 vs 43.8; p=0.004), anxiety (57.6 vs 47.0; p<0.001), and depression (53.1 vs 43.9; p<0.001).

Conclusions:

In this sample, insomnia, sleep quality, and QoL related to sleep, fatigue, anxiety, and depression were significantly worse in DSP patients with worse pain as measured by the BPI. Strategies to address sleep in patients with DSP may improve pain and quality of life. Further investigation of drivers of sleep impairment in DSP may provide an additional treatment strategy for management of neuropathic pain in DSP.