title: Patients with neck pain are less likely to improve if they experience poor sleep quality: a prospective study in routine practice.
abstract: OBJECTIVE
  To assess whether sleep quality (SQ) at baseline is associated with improvement in pain and disability at 3 months.
  
  
  METHODS
  Four hundred twenty-two subacute and chronic patients with neck pain (NP) were recruited in 32 physiotherapy, primary care, and specialized centers. NP, referred pain, disability, catastrophizing, depression, and SQ were assessed through validated questionnaires, upon recruitment and 3 months later. Correlations between baseline scores were calculated through the Spearman coefficient. Improvements in NP, disability, and SQ were defined as a reduction of ≥30% of baseline score. Six estimative logistic regression models were developed to assess the association between baseline SQ and improvement of NP, baseline SQ and improvement of disability, baseline NP and improvement of SQ, baseline disability and improvement of SQ, the evolutions of NP and SQ, and the evolutions of disability and SQ.
  
  
  RESULTS
  Most patients were subacute and mildly impaired. Regression models showed that better SQ at baseline was associated with improvement of NP (odds ratio=0.91 [95% confidence interval, 0.83-0.99]), but not disability (1.04 [0.95-1.13]); the improvement of SQ was associated with more severe NP at baseline (1.26 [1.07-1.49)], but not with baseline disability (0.99 [0.97-1.02]); and that improvement in SQ was associated with improvements in NP (3.48 [1.68-7.20]), and disability (5.02 [2.39-10.11]).
  
  
  CONCLUSIONS
  NP is less likely to improve in patients with poorer SQ, irrespective of age, sex, catastrophizing, depression, or treatments prescribed for NP. Future studies should confirm these results with more severely impaired patients.
authors.affiliation: *Departamento Científico †Spanish Back Pain Research Network, Fundación Kovacs ‡‡IBaD Clínica del Dolor-Majorca Spine and Pain Clinic ¶¶Centro Salud Arquitecto Bennassar ##Unidad de la Espalda Kovacs, Hospital de Cruz Roja Española, Palma de Mallorca #Centro de Fisioterapia Sergio Melis/Ronda Oeste, Mallorca ‡Institute of Biomedicine (IBIOMED), University of León ‡‡‡Departamento de Fisiología, Universidad de El País Vasco (UPV/EHU), Campus Universitario, Guipúzcoa §University of the Basque Country, Campus Universitario, Basque Country †††Escuela Universitaria Ciencias de la Salud, Universidad de León, Campus Universitario, Ponferrada, León ∥CIBER Epidemiología y Salud Pública (CIBERESP) §§Servicio de Reumatología, Hospital Clínic, Barcelona ¶Unidad de Bioestadística Clínica ∥∥Sección de Rehabilitación Reumatológica, Hospital Ramón y Cajal, IRICYS ††Physical Medicine and Rehabilitation Department, Faculty of Medicine, Complutense University, Madrid **Fisys Fisioterapia, Cantabria ***Unidad del Dolor, Hospital Mateu Orfila, Mahón §§§Departamento de Medicina Preventiva y Salud Pública, Universidad de El País Vasco (UPV/EHU), Campus Universitario, Vizcaya, Spain.
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Kovacs
authors.forename: Jesús
authors.initials: J
authors.lastname: Seco
authors.forename: Ana
authors.initials: A
authors.lastname: Royuela
authors.forename: Sergio
authors.initials: S
authors.lastname: Melis
authors.forename: Carlos
authors.initials: C
authors.lastname: Sánchez
authors.forename: María J
authors.initials: MJ
authors.lastname: Díaz-Arribas
authors.forename: Marcelo
authors.initials: M
authors.lastname: Meli
authors.forename: Montserrat
authors.initials: M
authors.lastname: Núñez
authors.forename: María E
authors.initials: ME
authors.lastname: Martínez-Rodríguez
authors.forename: Carmen
authors.initials: C
authors.lastname: Fernández
authors.forename: Mario
authors.initials: M
authors.lastname: Gestoso
authors.forename: Nicole
authors.initials: N
authors.lastname: Mufraggi
authors.forename: Jordi
authors.initials: J
authors.lastname: Moyá
authors.forename: Vicente
authors.initials: V
authors.lastname: Rodríguez-Pérez
authors.forename: Jon
authors.initials: J
authors.lastname: Torres-Unda
authors.forename: Natalia
authors.initials: N
authors.lastname: Burgos-Alonso
authors.forename: Inés
authors.initials: I
authors.lastname: Gago-Fernández
authors.forename: Víctor
authors.initials: V
authors.lastname: Abraira
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000150:complications / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D011446:Prospective Studies; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult