Detecting insomnia in patients with low back pain: accuracy of four self-report sleep measures

Alsaadi, Saad M.; McAuley, James H.; Hush, Julia M.; Bartlett, Delwyn J.; Henschke, Nicholas; Grunstein, Ronald R.; Maher, Christopher G.

doi:10.1186/1471-2474-14-196

Cited by 60 publications

(50 citation statements)

References 38 publications

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“…Alsaadi and his colleagues found similar results and showed that back pain and sleep disorders were associated with each other (Alsaadi et al, 2013). Sleep disorders can exacerbate pain and inflammatory processes.…”

Section: Discussionsupporting

confidence: 65%

“…Scores higher is related to the quality of sleep are more unfavorable (Buysse, Reynolds, Monk, Berman, & Kupfer, 1989). Reliability and validity of this questionnaire have been confirmed in other studies (Alsaadi et al, 2013;Farhadi Nasab & Azimi, 2008;Mollayeva et al, 2015). According to the designers of the questionnaire, a score greater than 5 indicates a poor sleep quality (Ağargün, Kara, & Anlar, 1996;Aloba, Adewuya, Ola, & Mapayi, 2007;Doi et al, 2000).…”

Section: Sleep Quality Assessmentsupporting

confidence: 49%

See 1 more Smart Citation

Factors Affecting Sleep Quality in Firefighters

Abbasi¹,

Rajabi²,

Yazdi³

et al. 2018

Sleep Hypn

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Background: Identifying factors affecting the quality of sleep in firefighters is of significant importance. Good sleep is one of the essential needs of firefighters, and poor sleep quality impairs their performance and decision making. The present study aimed to evaluate sleep quality and its relation with ergonomic, demographic, and psychological factors in firefighters employed in Qazvin. Methods: 118 firefighters from seven stations participated in this study. Data were gathered by questionnaires including demographic, Pittsburgh Sleep Quality Index, Beck Depression Inventory, HSE questionnaire for occupational stress, and Nordic questionnaire. Data were compared between two groups of firefighters with good and poor sleep quality. Then the data were analyzed using regression analysis. Results: 59.3% of firefighters had poor quality of sleep. Univariate analysis showed a significant correlation between sleep quality with musculoskeletal disorders, shift work, body mass index (BMI), and stress (P<0.05). In multivariate analysis, all variables except the occupational stress maintained their significant relationship with sleep quality. Conclusion: this study showed that musculoskeletal disorders (MSDs), shift work, and high body mass index are associated with poor sleep quality in firefighters. Proper timely interventions are suggested to prevent the complications of sleep disorders in firefighters.

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Section: Discussionsupporting

confidence: 65%

Section: Sleep Quality Assessmentsupporting

confidence: 49%

Factors Affecting Sleep Quality in Firefighters

Abbasi¹,

Rajabi²,

Yazdi³

et al. 2018

Sleep Hypn

View full text Add to dashboard Cite

show abstract

“…Any score higher than 5 is regarded as poor sleep quality. The validity of the questionnaire has been confirmed in the earlier studies (Alsaadi et al, 2013;Nasab, & Azimi 2008).…”

Section: Methodssupporting

confidence: 62%

“…The higher score demonstrates the higher risk of insomnia and need for medical assistance. The questionnaire was used by Morine and his coworkers for the first time (Alsaadi et al, 2013). The Kronbach' alpha of the questionnaire was 0.76 in the current study which is acceptable.…”

Section: Methodsmentioning

confidence: 95%

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Sleep Quality, Quality of Life and Insomnia Among Patients with Chronic Low Back Pain Compared to Normal Individuals

Abbasi¹,

Kazemifar²,

Fatorechi³

et al. 2018

Sleep Hypn

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Objective: Low back pain may affect various aspects of quality of life including sleep. There are some reports about prevalence of sleep disorders in patients with chronic low back pain. The present study was conducted to estimate sleep quality, quality of life, and insomnia in patients with chronic low back pain compared to age and sex matched control group. Methods: The present case-control study was performed on 140 persons (70 patients with chronic low back pain and 70 persons as control group). They were asked to fill Pittsburg questionnaire for evaluation of sleep quality, SF-36 questionnaire for evaluation of quality of life, and insomnia questionnaire. Also, the severity of their back pain was assessed using visual analogue scale (VAS). Results: Mean age of the studied persons was 49.88±11 and 48.33±10 years in the case and control groups, respectively (P-value>0.05). Thirty one persons of each group were male. Individuals in the case group had worse sleep quality (correlation coefficient 0.478 with severity of pain), more severe insomnia (correlation coefficient 0.386 with severity of pain), and lower quality of life (correlation coefficient 0.665 with severity of pain) compared to the control group. Conclusion: Results of the present study showed that patients with chronic low back pain have higher prevalence of insomnia, lower quality of life, and worse sleep quality when judged against control group. Also, this case-control study clearly showed the magnitude of the relationship between them.

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Cognitive Behavioral Therapy for Insomnia in Pain Management for Nonspecific Chronic Spinal Pain

Malfliet,

De Baets,

Bilterys

et al. 2024

JAMA Netw Open

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ImportanceInsomnia is highly prevalent in patients with nonspecific chronic spinal pain (nCSP). Given the close interaction between insomnia and pain, targeting sleep problems during therapy could improve treatment outcomes.ObjectiveTo evaluate the effectiveness of cognitive behavioral therapy for insomnia (CBTi) integrated in best-evidence pain management (BEPM) vs BEPM only in patients with nCSP and insomnia.Design, Setting, and ParticipantsA multicenter randomized clinical trial with 1-year follow-up was conducted between April 10, 2018, and April 30, 2022. Data and statistical analysis were performed between May 1, 2022, and April 24, 2023. Patients with nCSP and insomnia were evaluated using self-report and at-home polysomnography, to exclude underlying sleep pathologic factors. Participants were treated at the University Hospital Brussels or University Hospital Ghent, Belgium. Intention-to-treat analysis was performed.InterventionsParticipants were randomized to either CBTi-BEPM or BEPM only. Both groups received 18 treatment sessions over 14 weeks. The CBTi-BEPM treatment included 6 CBTi sessions and 12 BEPM sessions. The BEPM treatment included pain neuroscience education (3 sessions) and exercise therapy (9 sessions in the CBTi-BEPM group, 15 sessions in the BEPM-only group).Main Outcomes and MeasuresThe primary outcome was change in mean pain intensity (assessed with Brief Pain Inventory [BPI]) at 12 months after the intervention. Exploratory secondary outcomes included several pain- and sleep-related outcomes. Blinded outcome assessment took place at baseline, posttreatment, and at 3-, 6-, and 12-month follow-up.ResultsA total of 123 patients (mean [SD] age, 40.2 [11.18] years; 84 women [68.3%]) were included in the trial. In 99 participants (80.5%) with 12-month BPI data, the mean pain intensity at 12 months decreased by 1.976 points (reduction of 40%) in the CBTi-BEPM group and 1.006 points (reduction of 24%) points in the BEPM-only group. At 12 months, there was no significant difference in pain intensity change between groups (mean group difference, 0.970 points; 95% CI, −0.051 to 1.992; Cohen d, 2.665). Treatment with CBTi-BEPM resulted in a response for BPI average pain with a number needed to treat (NNT) of 4 observed during 12 months. On a preliminary basis, CBTi-BEPM was, consistently over time and analyses, more effective than BEPM only for improving insomnia severity (Cohen d, 4.319-8.961; NNT for response ranging from 2 to 4, and NNT for remission ranging from 5 to 12), sleep quality (Cohen d, 3.654-6.066), beliefs about sleep (Cohen d, 5.324-6.657), depressive symptoms (Cohen d, 2.935-3.361), and physical fatigue (Cohen d, 2.818-3.770). No serious adverse effects were reported.Conclusions and RelevanceIn this randomized clinical trial, adding CBTi to BEPM did not further improve pain intensity reduction for patients with nCSP and comorbid insomnia more than BEPM alone. Yet, as CBTi-BEPM led to significant and clinically important changes in insomnia severity and sleep quality, CBTi integrated in BEPM should be considered in the treatment of patients with nCSP and comorbid insomnia. Further research can investigate the patient characteristics that moderate the response to CBTi-BEPM in terms of pain-related outcomes, as understanding of these moderators may be of utmost clinical importance.Trial RegistrationClinical Trials.gov Identifier: NCT03482856

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Detecting insomnia in patients with low back pain: accuracy of four self-report sleep measures

Cited by 60 publications

References 38 publications

Factors Affecting Sleep Quality in Firefighters

Factors Affecting Sleep Quality in Firefighters

Sleep Quality, Quality of Life and Insomnia Among Patients with Chronic Low Back Pain Compared to Normal Individuals

Cognitive Behavioral Therapy for Insomnia in Pain Management for Nonspecific Chronic Spinal Pain

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