Observational studyPain research & management2026
Association of Baseline Systemic Immune-Inflammation Index With Severe Sleep Disturbance in Patients With Neuropathic Pain: A Prospective Longitudinal Observational Cohort Study.
Observational study in Pain research & management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Association of Baseline Systemic Immune-Inflammation Index With Severe Sleep Disturbance in Patients With Neuropathic Pain: A Prospective Longitudinal Observational Cohort Study.Pain research & management · 2026Observational
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5 authors.
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Abstract
backgroundPatients with neuropathic pain frequently experience impaired sleep quality. The systemic immune-inflammation index (SII) is a readily available blood-based inflammatory marker, but its association with sleep disturbance in neuropathic pain patients remains insufficiently defined.
methodsThis single-center prospective longitudinal observational cohort study enrolled 135 patients aged 40-65 years with neuropathic pain confirmed by the DN4 questionnaire, disease duration of 6-12 months, and pain inadequately controlled by conventional medication. Baseline severe sleep disturbance was defined using a prespecified severity-based threshold of PSQI > 10. Fasting blood and first-morning spot urine samples were collected at baseline and at the 1-month follow-up after PRF. SII was calculated as platelet count x neutrophil count/lymphocyte count. Native urinary melatonin concentration was measured by ELISA and reported as an unadjusted spot urine concentration. The primary analysis evaluated the association between baseline SII and severe sleep-disturbance status; post-PRF changes were interpreted as within-subject temporal changes because no control group was included.
resultsAt baseline, 73 of 135 patients met the prespecified criterion for severe sleep disturbance. Compared to the nonsevere group, the severe group had higher baseline SII (803.03 ± 111.45 vs. 604.21 ± 164.29, p < 0.001) and lower urinary melatonin concentration (8.32 ± 2.17 vs. 9.61 ± 2.72, p = 0.006). At the 1-month follow-up, severe sleep-disturbance status was present in 9 patients (McNemar test, p < 0.001). SII decreased, and urinary melatonin concentration increased in both baseline severity groups (all within-group p < 0.001). In a limited multivariable logistic regression model adjusted for available baseline covariates, baseline SII was associated with severe sleep-disturbance status (adjusted OR per 1-unit increase: 1.011; 95% CI: 1.007-1.014; p < 0.001). Exploratory ROC analysis yielded an apparent in-sample AUC of 0.833.
conclusionsHigher baseline SII was associated with severe sleep-disturbance status in this mixed neuropathic pain cohort. The observed longitudinal changes after PRF should be interpreted cautiously as within-subject temporal changes rather than PRF-specific effects. The findings are exploratory and do not establish causality, a direct inflammatory mechanism, or validated predictive performance.
trial registrationChinese Registry of Clinical Trials: ChiCTR2500103587.
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