{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:25:02Z","timestamp":1788449102161,"version":"build-2803163510"},"reference-count":59,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sleep\u2013wake disturbances are frequently reported by patients with chronic pain. Physical activity, recommended as a first\u2010line treatment for chronic pain, can be difficult to implement due to pain severity. This study aimed to assess the prevalence of insomnia and other sleep\u2013wake disturbances in a cohort of patients with chronic pain and to explore the influence of physical activity, opioid use, reported pain, and symptoms of depression and anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This clinical cross\u2010sectional study included 100 patients with chronic pain attending a specialist\u2010level pain clinic. Participants were consecutively enrolled, and sleep and physical activity were evaluated using accelerometers. Additional assessments included the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), symptoms of restless legs syndrome (RLS), STOP\u2010Bang score, pain intensity assessed by Numeric Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), and self\u2010reported level of physical activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, nearly all participants experienced sleep\u2013wake disturbances. Average sleep duration (hh:mm) was 5:30 (range, 1:46\u20139:52), and sleep efficiency was 64% (range, 28\u201381). Based on PSQI scores, 95% were classified as having poor sleep quality. Clinical insomnia (ISI \u2265\u200915p) was reported by 67%. A statistically significant correlation (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.31, 95% CI, 0.10\u20130.50) was found between sleep efficiency and level of physical activity and between ISI and HADS depression (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.41, 95% CI, 0.22\u20130.57).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A wide range of sleep\u2013wake disturbances were present in the examined cohort, highlighting the possible benefit of assessing sleep to optimise pain rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>In this cohort, nearly all patients with chronic pain experienced sleep\u2013wake disturbances, and none reached 85% sleep efficiency indicating stable sleep. These findings emphasise the need for a comprehensive assessment of sleep problems to improve the understanding and management of severe pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      : NCT04649281\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70330","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:15:27Z","timestamp":1783401327000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sleep\u2013Wake Disturbances in Patients With Chronic Pain\u2014Associations With Physical Activity Levels"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1035-2734","authenticated-orcid":false,"given":"Emma","family":"Varkey","sequence":"first","affiliation":[{"name":"Department of Occupational Therapy and Physical Therapy Sahlgrenska University Hospital\/\u00d6stra  Gothenburg Region V\u00e4stra G\u00f6taland Sweden"},{"name":"Department of Health and Rehabilitation\/Physiotherapy Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Olsson","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Anaesthesiology, Intensive Care Medicine and Pain Medicine Sahlgrenska University Hospital\/\u00d6stra  Gothenburg Region V\u00e4stra G\u00f6taland Sweden"},{"name":"Centre for Sleep and Wake Disorders Institute of Medicine, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Piasecki","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Anaesthesiology and Intensive Care Medicine Sahlgrenska University Hospital  M\u00f6lndal Region V\u00e4stra G\u00f6taland Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hedner","sequence":"additional","affiliation":[{"name":"Centre for Sleep and Wake Disorders Institute of Medicine, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludger","family":"Grote","sequence":"additional","affiliation":[{"name":"Centre for 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