Early Treatment of Pain Benefits Insomnia Treatment
劉志中(Chih-Chung Liu);葉宇記(Yu-Chi Yeh);孫孝倫(Hiaso-Lun Sun);李怡慧(Yi-Hui Lee);簡志誠(Chih-Cheng Chien);汪志雄(Chih-Shung Wong)
Background & Aims: Pain is known to be interrelated to sleep disturbance. Insomnia is prevalent among patients with chronic pain. Patients suffer from sleeping disorders are proved to be more sensitive to painful stimulation. Yet, the impact of pain management on insomnia, especially in Asia population, is seldom investigated. Therefore, we use a nationwide health insurance database in Taiwan with a population over 23 million to explore whether the early use of non-steroidal anti-inflammatory drugs (NSAIDs) for pain management may help patients with insomnia.Methods: We analyzed the data sourced from the Longitudinal Health Insurance Database 2000 (LHID 2000) of Taiwan National Health Insurance Research Database (NHIRD), and selected subjects who were newly diagnosed as insomnia by ICD-9-CM Codes and their treatment period longer than one month during 2000 to 2005, and study group were patients who were also early (within first quarter) use of NSAIDs after insomnia diagnosed. Wilcoxon rank sum test was used to exam the utility of hypnotics between groups in the subsequent four quarters.Results: 1,287 patients were sampled as insomnia from LHID 2000. 426 patients were selected as control group (insomniacs without use of NSAIDs) and 10 patients were identified as the study group (insomniacs with NSAIDs use). The average usage of hypnotics and sedatives of both groups decreased over time, and this is lower in the study group than in the control group. The proportion of patients stayed on either hypnotics or sedatives prescriptions in both groups were decreased in the follow-up quarters, and this is significantly lower in study group after the third quarter.Conclusion: The results of such a large population-based health insurance database may provide useful evidence for medical decision. Based on current data, we suggest that proper identification and management of underlying or co-existing painful disorders might be beneficial for patients suffering from sleep disturbance.