title: Sleep quality and nocturnal pain in patients with shoulder disorders.
abstract: BACKGROUND
  Nocturnal shoulder pain resulting in poor sleep quality is a common finding in patients with shoulder disease. The purpose of this paper was to describe and to compare the sleep quality, pain, and function in adult subjects who have been diagnosed with rotator cuff disorders, osteoarthritis, or adhesive capsulitis (AC).
  
  
  METHODS
  Patients completed a clinical assessment and comprehensive questionnaire regarding their current medical health history, shoulder symptoms, and impact of their symptoms on activities of daily living and quality of sleep.
  
  
  RESULTS
  The study analyzed 343 patients with an average age of 57.4 years. The mean Single Assessment Numeric Evaluation score for AC was 34%, which was significantly lower than the score for the subacromial impingement syndrome group of 53% (P = .007). The mean American Shoulder and Elbow Surgeons scale score for AC was 38, which was also significantly lower than the score for the subacromial impingement syndrome group of 51 (P = .007). There were no significant differences in pain, with mean scores ranging from 4.90 to 5.82 for diagnostic subgroups on a visual analog scale (P = .28). Sleep quality was significantly poorer in the AC group (P = .008), with a mean Pittsburgh Sleep Quality Index score of 12.07. Specific subcomponents of the Pittsburgh Sleep Quality Index that had a significant impact on sleep interruption included sleep quality, sleep duration, and habitual sleep efficiency in the AC group (P < .05).
  
  
  CONCLUSIONS
  This study shows that whereas many patients with shoulder disease may have sleep-related issues, patients with adhesive capsulitis are particularly vulnerable to reduced sleep quality.
authors.affiliation: Department of Physical Therapy, UT Southwestern School of Health Professions, Dallas, TX USA.
authors.forename: Edward P
authors.initials: EP
authors.lastname: Mulligan
authors.affiliation: Department of Physical Therapy, UT Southwestern School of Health Professions, Dallas, TX USA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Brunette
authors.affiliation: School of Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Shirley
authors.affiliation: UT Southwestern Medical Center, Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, Dallas, TX, USA. Electronic address: michael.khazzam@utsouthwestern.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Khazzam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000150:complications; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications; D010865:Pilot Projects; D011446:Prospective Studies; D000070636:Rotator Cuff Injuries; D019534:Shoulder Impingement Syndrome / Q000150:complications; D012785:Shoulder Joint; D020069:Shoulder Pain / Q000209:etiology*; D012893:Sleep Wake Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires; D052256:Tendinopathy / Q000150:complications; D055815:Young Adult
keywords: Adhesive capsulitis; nocturnal pain; sleep quality