Pain interference and quality of life in combat veterans: Examining the roles of posttraumatic stress disorder, traumatic brain injury, and sleep quality.
Anna S Ord, Sagar S Lad, Robert D Shura and 3 others
PMID 32378923WHAT IT FOUND
Among 289 combat veterans, worse PTSD, deployment TBI severity, and poor sleep were linked to more pain that limits daily life.
Poor sleep and PTSD were linked to quality of life. TBI severity was not, after sleep and PTSD were included.
Key findings
01PTSD symptom severity, deployment TBI severity, and poor sleep quality were significantly associated with higher pain interference.
02PTSD symptom severity and sleep quality were significantly associated with quality of life, while deployment TBI severity was not significant after covariates and PTSD severity were considered.
03Pain interference was significantly associated with lower quality of life, but it was no longer significant after sleep quality was added.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The data were cross-sectional, so the study cannot show that PTSD, TBI, or sleep caused pain interference or quality of life differences. The study measured pain interference, but not pain intensity, quality, location, or diagnosis. Sleep quality was measured by a subjective questionnaire, not by objective sleep testing or formal sleep disorder diagnosis. The sleep measure did not comprehensively assess all sleep disturbances, including nightmares, which may matter in a sample with many current PTSD diagnoses. The quality of life measure was altered for participants without TBI history, and the effects of those alterations are not fully known. Veterans with active substance use disorders were excluded, so results may not apply to Veterans with those comorbid conditions. Symptom validity testing did not include specific measures of overreported somatic complaints or pain symptoms. The sample had no severe TBI cases, so findings do not apply to severe TBI. The sample was mostly male, so results may not generalize well to female Veterans.
The easy way to misread this
Do not conclude that treatment for sleep, PTSD, or TBI will reduce pain interference or improve quality of life. The study measured associations at one time point and did not test treatment.