Sleep Disturbance and Its Clinical Implication in Patients with Adult Spinal Deformity: Comparison with Lumbar Spinal Stenosis

Abstract

Purpose. e purpose of this study was to investigate the prevalence of sleep disturbance and its clinical implication in patients with ASD. Methods. A total of 44 patients with ASD and 137 patients with lumbar spinal stenosis (LSS) were enrolled in the study. Forty four patients were selected from the LSS group after propensity score matching. Global Pittsburgh Sleep Quality Index (PSQI) score, demographic data, visual analog scale (VAS) score for back and leg pain, Oswestry Disability Index (ODI), and EuroQol 5-dimension questionnaire (EQ-5D) were compared between both groups. Multiple regression analysis was performed with VAS for back pain as the dependent variable and age, sex, PSQI, and VAS for leg pain as the independent variables in the ASD group. Results. 33 (75.0%) and 32 (72.7%) patients were classified as poor sleepers in the ASD group and the LSS group, respectively. In the ASD group, the VAS score for back pain was 7.7 ± 1.7 in the poor sleeper group and 5.6 ± 2.2 in the nonpoor sleeper group. In the LSS group, poor sleep quality was associated with the ODI score, ODI score without a sleep component, and EQ-5D. e regression model for predicting VAS for back pain in the ASD group suggested that poor sleep quality and increased leg pain were associated with increased back pain. Conclusions. Because sleep quality is a critical factor in augmenting back pain in patients with ASD, this study underlines the need to investigate sleep quality during the routine examination of patients with ASD.

Prevalence of Sleep Disturbance and Its Risk Factors in Patients Who Undergo Surgical Treatment for Degenerative Spinal Disease: A Nationwide Study of 106,837 Patients

“…Compared with the prevalence of sleep disturbance in recent studies in the general population (1.6 to 18.6%) [ 23 ], and in patients with degenerative spinal disease (11 to 74%) [ 12 , 13 , 14 , 15 , 16 , 17 ], the prevalence of sleep disturbance in our cohort (3.8 to 5.5%, Table 3 ) is quite low. This difference results from the different methods used to evaluate sleep disturbance.…”

“…Chronic pain is one of the major risk factors associated with sleep disturbance [ 8 , 9 ], and sleep disturbance has been reported to be prevalent in patients with degenerative joint diseases of the extremities [ 10 , 11 ]. Recent studies have revealed that sleep disturbance is also prevalent in patients with degenerative spinal disease, with a reported prevalence ranging from 11 to 74% [ 12 , 13 , 14 , 15 ]. Interestingly, studies have identified that in patients with degenerative spinal disease, the radiologic severity of degeneration is a stronger predictor of sleep disturbance than overall pain intensity [ 12 , 13 ].…”

“…However, sleep disturbance has hitherto not been a matter of concern to spinal surgeons, and few studies have investigated the epidemiology of sleep disturbance in patients who underwent spinal surgery. Although several recent studies have been conducted for this purpose, they had the following limitations [ 12 , 13 , 14 , 16 , 17 ]. First, most of these studies are single-center studies with a limited number of patients.…”

Sleep Quality in Spine Surgery

“…One study demonstrated that patients with adult spinal deformity experiencing more severe sleep problems reported worse back pain. Conversely, for patients with lumbar spinal stenosis, the presence of sleep disturbances was linked to multilevel stenosis, higher disability, and worse quality of life scores 10. A cross-sectional study demonstrated about two-thirds of patients with lumbar spinal stenosis reported sleep disturbance.…”

“…Conversely, for patients with lumbar spinal stenosis, the presence of sleep disturbances was linked to multilevel stenosis, higher disability, and worse quality of life scores. 10 A cross-sectional study demonstrated about two-thirds of patients with lumbar spinal stenosis reported sleep disturbance. The authors demonstrated that sleep disturbance was significantly associated with severe foraminal stenosis, female sex, and worse depressive burden.…”