Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysis

Background: Chronic pain and depression represent two global health problems with considerable economic consequences. Although existing literature reports on the relation between depression and pain conditions, meta-analytic evidence backing the mediating role of sleep disturbance as one of the main...

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Authors: Karimi, Roya, Mallah, Narmeen, Scherer, Ronny, Rodríguez Cano, Rubén, Takkouche, Bahi
Format: article
Publication Date:2023
Country:España
Institution:Universidad de Santiago de Compostela (USC)
Repository:Minerva. Repositorio Institucional de la Universidad de Santiago de Compostela
Language:English
OAI Identifier:oai:minerva.usc.gal:10347/43758
Online Access:https://hdl.handle.net/10347/43758
Access Level:Open access
Keyword:chronic pain
depression
meta-analysis
pain
sleep
structural equation modelling
3210 Medicina preventiva
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spelling Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysisKarimi, RoyaMallah, NarmeenScherer, RonnyRodríguez Cano, RubénTakkouche, Bahichronic paindepressionmeta-analysispainsleepstructural equation modelling3210 Medicina preventivaBackground: Chronic pain and depression represent two global health problems with considerable economic consequences. Although existing literature reports on the relation between depression and pain conditions, meta-analytic evidence backing the mediating role of sleep disturbance as one of the main symptoms of depression is scarce. To examine the extent to which sleep disturbance mediates the depression–chronic pain association, we conducted a systematic review and meta-analysis of the associations of chronic pain, depression, and sleep quality. Methods: We systematically searched for literature in MEDLINE and other relevant databases and identified cohort and case–control studies on depression, sleep disturbance, and chronic pain. Forty-nine studies were eligible, with a total population of 120 489 individuals. We obtained direct and indirect path coefficients via two-stage meta-analytic structural equation modelling, examined heterogeneity via subgroup analyses, and evaluated primary studies quality. Results: We found a significant, partial mediation effect of sleep disturbance on the relation between depression and chronic pain. The pooled path coefficient (coef.) of the indirect effect was 0.03 (95% confidence interval [CI]: 0.01–0.05) and accounted for 12.5% of the total effect of depression on chronic pain. This indirect effect also existed for cohort studies (coef. 0.02; 95% CI: 0.002–0.04), European studies (coef. 0.03; 95% CI: 0.004–0.05), and studies that adjusted for confounders (coef. 0.04; 95% CI: 0.01–0.09). Conclusions: Sleep disturbance partially mediates the association between depression and pain. Although plausible mechanisms could explain this mediation effect, other explanations, including reverse causation, must be further explored.ElsevierUniversidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina20232023-01-0120232023-01-01journal articlehttp://purl.org/coar/resource_type/c_6501AMhttp://purl.org/coar/version/c_ab4af688f83e57aainfo:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10347/43758reponame:Minerva. Repositorio Institucional de la Universidad de Santiago de Compostelainstname:Universidad de Santiago de Compostela (USC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:minerva.usc.gal:10347/437582026-06-15T12:47:27Z
dc.title.none.fl_str_mv Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysis
title Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysis
spellingShingle Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysis
Karimi, Roya
chronic pain
depression
meta-analysis
pain
sleep
structural equation modelling
3210 Medicina preventiva
title_short Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysis
title_full Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysis
title_fullStr Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysis
title_full_unstemmed Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysis
title_sort Sleep quality as a mediator of the relation between depression and pain: A systematic review and meta-analysis
dc.creator.none.fl_str_mv Karimi, Roya
Mallah, Narmeen
Scherer, Ronny
Rodríguez Cano, Rubén
Takkouche, Bahi
author Karimi, Roya
author_facet Karimi, Roya
Mallah, Narmeen
Scherer, Ronny
Rodríguez Cano, Rubén
Takkouche, Bahi
author_role author
author2 Mallah, Narmeen
Scherer, Ronny
Rodríguez Cano, Rubén
Takkouche, Bahi
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
dc.subject.none.fl_str_mv chronic pain
depression
meta-analysis
pain
sleep
structural equation modelling
3210 Medicina preventiva
topic chronic pain
depression
meta-analysis
pain
sleep
structural equation modelling
3210 Medicina preventiva
description Background: Chronic pain and depression represent two global health problems with considerable economic consequences. Although existing literature reports on the relation between depression and pain conditions, meta-analytic evidence backing the mediating role of sleep disturbance as one of the main symptoms of depression is scarce. To examine the extent to which sleep disturbance mediates the depression–chronic pain association, we conducted a systematic review and meta-analysis of the associations of chronic pain, depression, and sleep quality. Methods: We systematically searched for literature in MEDLINE and other relevant databases and identified cohort and case–control studies on depression, sleep disturbance, and chronic pain. Forty-nine studies were eligible, with a total population of 120 489 individuals. We obtained direct and indirect path coefficients via two-stage meta-analytic structural equation modelling, examined heterogeneity via subgroup analyses, and evaluated primary studies quality. Results: We found a significant, partial mediation effect of sleep disturbance on the relation between depression and chronic pain. The pooled path coefficient (coef.) of the indirect effect was 0.03 (95% confidence interval [CI]: 0.01–0.05) and accounted for 12.5% of the total effect of depression on chronic pain. This indirect effect also existed for cohort studies (coef. 0.02; 95% CI: 0.002–0.04), European studies (coef. 0.03; 95% CI: 0.004–0.05), and studies that adjusted for confounders (coef. 0.04; 95% CI: 0.01–0.09). Conclusions: Sleep disturbance partially mediates the association between depression and pain. Although plausible mechanisms could explain this mediation effect, other explanations, including reverse causation, must be further explored.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
AM
http://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10347/43758
url https://hdl.handle.net/10347/43758
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Minerva. Repositorio Institucional de la Universidad de Santiago de Compostela
instname:Universidad de Santiago de Compostela (USC)
instname_str Universidad de Santiago de Compostela (USC)
reponame_str Minerva. Repositorio Institucional de la Universidad de Santiago de Compostela
collection Minerva. Repositorio Institucional de la Universidad de Santiago de Compostela
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,228081

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