title: Pain-related Sleep Disturbance: A Prospective Study With Repeated Measures.
abstract: OBJECTIVE
  Pain has been found to be associated with poor sleep quality, awakenings, and shorter sleep time. There is a need to understand the relationship of pain and sleep over time to adequately manage the pain disorder and its consequences. The objectives of this study were to establish the prevalence of sleep disturbance in patients with acute or persistent low back pain (LBP), to investigate the correlation between pain and sleep disturbance and to explore the influence of pain on sleep disturbance.
  
  
  METHODS
  Data from a prospective observational study of 233 patients with acute and persistent LBP were used. Twenty-six weekly pain reports and monthly (weeks 2, 6, 10, 14, 18, 22, and 26) sleep reports were collected with text messages. The prevalence of sleep disturbance, the correlation of pain and sleep disturbance, and the risk of reporting disturbed sleep after experiencing LBP were calculated.
  
  
  RESULTS
  Sleep disturbance was reported by 67% of the sample. Among patients with acute and persistent LBP, the prevalence was 55% and 76%, respectively. Measures of pain and sleep disturbance were significantly correlated. Compared with being pain free, the risk of reporting sleep disturbance after experiencing pain the previous week was significantly increased (relative risk=2.1 to 5.8), and a dose-response between the number of days with pain and the risk of sleep disturbance was found.
  
  
  CONCLUSIONS
  This study used repeated measures of both pain and sleep disturbance. The results were in line with previous research, confirming that sleep disturbance was found in the majority of patients with LBP. Pain and sleep measures were significantly correlated, and there was an increased risk of reporting sleep disturbance after experiencing LBP.
authors.affiliation: Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Iben
authors.initials: I
authors.lastname: Axén
mesh_terms: D000328:Adult; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology