A patient with chronic pain tells the nurse that he “rarely sleeps more than thr

2 -- Depression is clearly linked to pain: Serotonin, a neurotransmitter, is involved in the modulation of pain in the central nervous system. In clinically -depressed people, serotonin is decreased, which leads to an increase in pain sensations. Fatigue, the lack of sleep, and pain are interrelated concepts. The focus of this question is the patient’s chronic pain history. There is no information available to support the onset of chronic insomnia, inferences concerning pain tolerance, or the presence of adult attention deficit disorder.

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