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Post herpetic neuralgia (PHN) interferes with patients’ quality of life, and disturbed sleep is a prevalent complaint.
The sleep
patterns are greatly affected in post herpetic neuralgia patients causing
inadequate or poor quality sleep. In normal adults and epileptic patients,
gabapentin is thought to improve sleep quality by increasing slow-wave sleep.
Thus, findings of this study depict that a direct effect on sleep may have
contributed to improvements in BPISI independent of pain reduction.
Post herpetic
neuralgia (PHN) interferes with patients’ quality of life, and disturbed sleep
is a prevalent complaint. Pain-associated sleep interference in turn enhances
pain and/or reduces pain tolerance. Therefore, reducing sleep interference by
pain, in addition to pain control, may improve patient care. To address this
notion, we characterized relationships among changes in pain intensity, sleep
interference, and overall impression of improvement in PHN patients treated
with gastro retentive gabapentin (G-GR).
Patients with PHN
(n = 556) received G-GR 1800 mg once-daily in two phase 3 and one phase 4
study. Visual Analog Scale (VAS) and Brief Pain Inventory (BPI) were completed
at baseline and the end of study. Patients’ Global Impression of Change (PGIC)
was completed at the end of study. Regression analyses examined relationships
between VAS, BPI sleep interference by pain, and PGIC.
At the end of
treatment, 53.7 and 63.2 % of patients reported a ≥30 % reduction in VAS and
BPI pain-associated sleep interference (BPISI) respectively; 46.3 % reported
feeling “Much” or “Very Much” improved on the PGIC. There were positive
correlations between the percent reductions in VAS and BPISI; both correlated with
PGIC improvements. Percent changes in VAS and BPISI were significant
(p < 0.0001 and p = 0.0082, respectively), and were independent predictors
of feeling “Much” or “Very Much” improved on the PGIC.
Reductions in
pain intensity and in BPISI were correlated, and both also correlated with
overall impression of improvement for patients with PHN treated with G-GR. Both
pain relief and improvement BPISI independently predicted improvement in PGIC.
For optimal patient care, clinicians should consider reducing the impact of
pain on quality of sleep as well as overall pain reduction.
Health Qual Life Outcomes
Relationship between pain relief, reduction in pain-associated sleep interference, and overall impression of improvement in patients with postherpetic neuralgia treated with extended-release gabapentin
Neel Mehta et al.
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