Sleep disturbance in patients with chronic low back pain.
OBJECTIVE
To document the relationship between sleep disturbance and chronic low back pain in patients referred to a physical medicine and rehabilitation clinic.


METHODS
This is a prospective cross-sectional survey of 268 patients 18 yrs or older being evaluated for low back pain of greater than 6 months at a tertiary medical center. The survey consisted of a 43-item composite form that contained the Short-Form McGill Pain Questionnaire (SF-MPQ); the Pittsburgh Sleep Quality Index (PSQI); a pain visual analog scale (VAS); and questions regarding bed type, sleep position, and patients' sleep description.


RESULTS
There was a significant relationship between pain and sleep (P<0.0005) with a 55% increase in the proportion of subjects reporting restless/light sleep after pain onset. There was no corresponding increase in sleep medication use. There was a significant direct correlation between SF-MPQ and PSQI (r=0.44, P<0.0005); between PSQI and VAS (r=0.41, P<0.0005); and between overall quality of sleep and VAS (r=0.31, P<0.0005). Finally, PSQI scores were the worst in subjects sleeping on an orthopedic mattress (P=0.001).


CONCLUSIONS
Chronic low back pain significantly affects quality of sleep. Sleep problems should be addressed as an integral part of the pain management plan.
Marin
Raul
R
Physical Medicine & Rehabilitation Service, Department of Orthopedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC, USA.
Cyhan
Tamara
T
Miklos
Wendy
W
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001513:Beds / Q000145:classification / Q000706:statistics & numerical data; D015984:Causality; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015995:Prevalence; D011446:Prospective Studies; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology*