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

Abstract

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.

Are Changes in Sleep Quality/Quantity or Baseline Sleep Parameters Related to Changes in Clinical Outcomes in Patients With Nonspecific Chronic Low Back Pain?

“…However, it remains unclear whether baseline sleep quality/quantity can predict future LBP-related outcomes in individuals with CLBP. Our findings reveal a paucity of relevant research although many individuals with CLBP experience sleep disturbance 14,18,19,22. Our results also underscore the importance of determining the causal relations between sleep and pain/function in individuals with CLBP, which may improve the assessments and treatments of these individuals.…”

“…[14][15][16][17] Notably, patients with higher CLBP intensity showed significantly poorer selfreported sleep quality. [18][19][20][21] Studies also found that over 55% of patients with CLBP experienced sleep disturbance, 14,18,19,22 which might manifest as insufficient sleep, frequent awakening, a long sleep latency, difficulty in initiating or maintaining sleep, and/or waking up too early. 23,24 Although speculative, poor sleep may upregulate neuroinflammatory cytokines, which are thought to be related to the pathogenesis of CLBP and aggravation of pain sensitization.…”

“…While multiple factors may affect the development, maintenance, and recurrence of LBP (eg, females, older age, occupations, anxiety, depression, scoliosis, facet degeneration, Modic changes, paraspinal muscle dysfunction, and neuroinflammation),7–13 some studies have suggested that sleep disturbance is related to the duration or intensity of LBP in patients with CLBP 14–17. Notably, patients with higher CLBP intensity showed significantly poorer self-reported sleep quality 18–21. Studies also found that over 55% of patients with CLBP experienced sleep disturbance,14,18,19,22 which might manifest as insufficient sleep, frequent awakening, a long sleep latency, difficulty in initiating or maintaining sleep, and/or waking up too early 23,24.…”

Increase in Cannabis Use Among Adults With Rheumatic Diseases: Results From a 2014–2019 United States Observational Study

“…Recent advances for patients with rheumatic diseases include more treatment options with improved outcomes, yet there remains an unmet need with pain (1)(2)(3)(4). While pain is sometimes treated as a single dimension of a patient's health-related quality of life, many patients with chronic pain also experience associated symptoms in other dimensions including insomnia, anxiety, and depression (5)(6)(7)(8)(9)(10). Pain control is listed as one of the highest priorities by patients with rheumatoid arthritis (RA) (11); these patients often turn to alternative treatments to cope with pain, including acupuncture/acupressure, hypnosis, herbal therapies, and cannabis (12)(13)(14)(15)(16)(17).…”

Insomnia in chronic non-specific low back pain

“…Важно отметить, что пациенты с ХНЛ имеют более низкое КЖ, худшее качество сна, чем пациенты без боли [2,15]. Влияние хронической боли на сон описывается как порочный круг с взаимным пагубным влиянием боли и нарушений сна [16].…”