title: Spinal pain--good sleep matters: a secondary analysis of a randomized controlled trial.
abstract: OBJECTIVE
  The estimated prevalence of poor sleep in patients with non-specific chronic low back pain is estimated to 64% in the adult population. The annual cost for musculoskeletal pain and reported poor sleep is estimated to be billions of dollars annually in the US. The aim of this cohort study with one-year follow-up was to explore the role of impaired sleep with daytime consequence on the prognosis of non-specific neck and/or back pain.
  
  
  METHODS
  Secondary analysis of a randomized controlled trial, including 409 patients.
  
  
  RESULTS
  Patients with good sleep at baseline were more likely to experience a minimal clinically important difference in pain [OR 2.03 (95% CI 1.22-3.38)] and disability [OR 1.85 (95% CI 1.04-3.30)] compared to patients with impaired sleep at one-year follow-up.
  
  
  CONCLUSIONS
  Patients with non-specific neck and/or back pain and self-reported good sleep are more likely to experience a minimal clinically important difference in pain and disability compared to patients with impaired sleep with daytime consequence.
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-17177, Stockholm, Sweden. kari.paanalahti@ki.se.|Scandinavian College of Naprapathic Manual Medicine, Kräftriket 23A, SE-11419, Stockholm, Sweden. kari.paanalahti@ki.se.
authors.forename: Kari
authors.initials: K
authors.lastname: Paanalahti
authors.affiliation: Department of Internal Medicine, Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistrasse 24, 8032, Zurich, Switzerland.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Wertli
authors.affiliation: Department of Internal Medicine, Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistrasse 24, 8032, Zurich, Switzerland.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Held
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-17177, Stockholm, Sweden.|Stressforskningsinstitutet, Stockholms universitet, SE-10691, Stockholm, Sweden.
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Åkerstedt
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-17177, Stockholm, Sweden.
authors.forename: Lena W
authors.initials: LW
authors.lastname: Holm
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-17177, Stockholm, Sweden.|Occupational and Industrial Orthopaedic Center (OIOC), NYU Hospital for Joint Diseases, New York University Langone Medical Center, 63 Downing Street, New York, NY, 10014, USA.
authors.forename: Margareta
authors.initials: M
authors.lastname: Nordin
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-17177, Stockholm, Sweden.|Scandinavian College of Naprapathic Manual Medicine, Kräftriket 23A, SE-11419, Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Skillgate
mesh_terms: D000328:Adult; D001416:Back Pain / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods; D019547:Neck Pain / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D010147:Pain Measurement / Q000379:methods; D011379:Prognosis; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000523:psychology; D016896:Treatment Outcome
keywords: Back pain; Impaired sleep; Naprapathy; Neck pain; Spinal pain