Keiko Yamada1,2, Yasuhiko Kubota3, Yuji Shimizu3,4, Renzhe Cui1, Yasuko Mori5, Yoshinobu Okuno6, Hideo Asada7, Koichi Yamanishi8, Hiroyasu Iso1. 1. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. 2. Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan. 3. Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan. 4. Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 5. Division of Clinical Virology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan. 6. The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan. 7. Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Nara, Japan. 8. National Institute of Biomedical Innovation, Ibaraki, Osaka, Japan.
Abstract
OBJECTIVES: There have been no community-based studies investigating the association between sleep duration and postherpetic neuralgia (PHN) development. The aim of the current study was to examine the association of sleep with herpes zoster (HZ) incidence and PHN. METHODS: In total, 12,329 residents (ages 50 to 103 years) of Shozu County, Japan, participated in our study from December 2009 to November 2010 and were followed up for 3 years. At baseline, the participants completed self-administered health questionnaires, including those on usual sleep duration. Three dermatologists diagnosed HZ on the basis of clinical symptoms and virus identification testing by polymerase chain reaction and serological tests, and evaluated pain using a modified Zoster Brief Pain Inventory survey form via telephone. We used a Cox proportional hazard regression model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident HZ and PHN. We also performed mediation analysis to examine whether hyperesthesia and acute pain intensity mediated the association between sleep shortage and chronic pain intensity. RESULTS: During follow-up, 400 cases of HZ were identified. Of these, 55 participants developed PHN. Sleep duration was not associated with HZ incidence. Sleep shortage increased the risk for PHN (HR 2.02 [95% CI: 1.06 to 3.85]). Hyperesthesia and acute pain intensity mediated the association between sleep shortage and chronic pain intensity (indirect/total effect ratio = 50% mediation). CONCLUSIONS: Sleep shortage was associated with increased risk for PHN, and hyperesthesia and acute pain intensity appeared to mediate this association. Sleep shortage may be a novel risk factor for PHN.
OBJECTIVES: There have been no community-based studies investigating the association between sleep duration and postherpetic neuralgia (PHN) development. The aim of the current study was to examine the association of sleep with herpes zoster (HZ) incidence and PHN. METHODS: In total, 12,329 residents (ages 50 to 103 years) of Shozu County, Japan, participated in our study from December 2009 to November 2010 and were followed up for 3 years. At baseline, the participants completed self-administered health questionnaires, including those on usual sleep duration. Three dermatologists diagnosed HZ on the basis of clinical symptoms and virus identification testing by polymerase chain reaction and serological tests, and evaluated pain using a modified Zoster Brief Pain Inventory survey form via telephone. We used a Cox proportional hazard regression model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident HZ and PHN. We also performed mediation analysis to examine whether hyperesthesia and acute pain intensity mediated the association between sleep shortage and chronic pain intensity. RESULTS: During follow-up, 400 cases of HZ were identified. Of these, 55 participants developed PHN. Sleep duration was not associated with HZ incidence. Sleep shortage increased the risk for PHN (HR 2.02 [95% CI: 1.06 to 3.85]). Hyperesthesia and acute pain intensity mediated the association between sleep shortage and chronic pain intensity (indirect/total effect ratio = 50% mediation). CONCLUSIONS: Sleep shortage was associated with increased risk for PHN, and hyperesthesia and acute pain intensity appeared to mediate this association. Sleep shortage may be a novel risk factor for PHN.
Authors: Jonathan W Cheah; Richard Danilkowicz; Carolyn Hutyra; Brian Lewis; Steve Olson; Emily Poehlein; Cynthia L Green; Richard Mather Journal: Arthrosc Sports Med Rehabil Date: 2022-01-05