Subjective Sleep Disturbance in Chronic Back Pain

Atkinson, J. H.; Ancoli‐Israel, Sonia; Slater, Mark A.; Garfin, Steven R.; Gillin, Christian

doi:10.1097/00002508-198812000-00007

Cited by 142 publications

(81 citation statements)

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“…In their sample of patients with nonmalignant chronic pain, Menefee et al (54) have shown that pain interferes with sleep quality only in patients reporting higher levels of pain intensity. However, other studies have also shown weak or no relationship between pain intensity and sleep complaints in various medical populations (32,38,55).…”

Section: Discussionmentioning

confidence: 95%

Determinants of sleep quality in women with systemic lupus erythematosus

Costa

Bernatsky

Dritsa

et al. 2005

Arthritis & Rheumatism

126

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Objective. To characterize sleep complaints in women with systemic lupus erythematosus (SLE) and to identify correlates of sleep quality. Methods. Sleep quality in 100 women with SLE was assessed using the Pittsburgh Sleep Quality Index (PSQI). Participants completed standardized questionnaires assessing depressed mood, leisure time physical activity, functional disability, and pain severity. A clinical examination determined disease activity, cumulative damage, and whether patients fulfilled the American College of Rheumatology criteria for fibromyalgia. A series of hierarchical multiple regressions were computed. Results. The mean ؎ SD global PSQI score was 6.98 ؎ 4.03, with moderate to severe sleep impairment reported by 56% of the sample. The first model testing the importance of demographic factors was not statistically significant. In the disease-related model, the use of prednisone and functional disability both contributed to poor sleep quality (P < 0.001). The addition of level of exercise participation to the demographic set significantly added to the model (P ‫؍‬ 0.001). Depression significantly added to the demographic set, explaining 29% of the variance (P < 0.0001). When these variables, along with disease related variables, were simultaneously regressed on the PSQI Global Score, only depressed mood appeared as a significant independent determinant of global sleep quality (P < 0.001). However, the point estimates for the Beta coefficients were consistent with effects for lack of exercise and prednisone use. Conclusion. A significant proportion of women with SLE suffer from poor sleep quality. The findings suggest that depressed mood, prednisone use, and lack of exercise contribute to decreased overall sleep quality.

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Section: Discussionmentioning

confidence: 95%

Determinants of sleep quality in women with systemic lupus erythematosus

Costa

Bernatsky

Dritsa

et al. 2005

Arthritis & Rheumatism

126

View full text Add to dashboard Cite

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“…In general, pain severity does not seem to be predictive for poorer sleep as often as mood, but in most studies, sleep disturbances and high pain intensities coincide. [11][12][13][14]31 However, pain severity was found to be predictive for falling asleep and for staying asleep in a study on patients with spinal cord injuries. 17 Relation between pain and sleep Several studies have reported that patients with pain report poorer sleep quality.…”

Section: Discussionmentioning

confidence: 98%

“…As one of the major consequences of SCI, pain has been found to affect quality of life, [1][2][3][4][5][6] leisure time activities, 5,7 vocational status, 7,8 and sexuality. 9 In non-SCI populations, poor sleep quality has been found in patients suffering from different health conditions such as obstructive pulmonary diseases, diabetes, rheumatic diseases, 10 and chronic pain conditions [11][12][13][14] as well as in patients suffering from affective disorders. 15 Few studies, however, have focused on the quality of sleep in SCI populations.…”

Section: Introductionmentioning

confidence: 99%

Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain

2004

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Study design: A cross-sectional descriptive study of self-reported quality of sleep in individuals with a spinal cord injury (SCI). Objectives: To assess and describe subjective quality of sleep in patients with SCI, with and without pain. Setting: Spinalis SCI unit, Stockholm, Sweden. Methods: A total of 230 patients with an SCI were mailed a questionnaire containing queries about pain intensities, pain unpleasantness, mood, and sleep quality (Basic Nordic Sleep Questionnaire) to assess quality of sleep in patients with SCI with and without pain. Results: Of the 192 questionnaires that were returned (response rate 83.4%), 191 were analysed. Patients were divided into three groups: (1) those who reported no pain (n ¼ 50), (2) those who reported intermittent pain (n ¼ 42), and (3) those who suffered from continuous pain (n ¼ 99). Patients suffering from continuous pain rated pain intensity and unpleasantness significantly higher than those who only suffered from intermittent pain. The group with continuous pain also reported the poorest quality of sleep and the highest ratings of anxiety and depression of the three groups. Anxiety, together with pain intensity and depression, were the main predictors for poor sleep quality. Conclusions: Poor subjective sleep quality was associated with higher ratings of pain intensity, anxiety, and depression. It is possible that melatonin serves as a modulator of these different aspects. Sponsorship: This study was made possible by grants from Spinalis Foundation.Spinal Cord (2005) 43, 85-95.

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“…Using the sleep item from the Roland and Morris Disability Questionnaire ''I sleep less well because of my back'', we found that 58.9% (95% CI 56.4-60.7%) of the participants reported that their back pain disturbed their sleep. This is slightly higher than the prevalence rates reported in previous studies conducted in smaller more homogeneous samples where the rates ranged from 50 to 55% [7,11,20,21]. Given the effects of poor sleep, for example increased fatigue, daytime sleepiness and low mood [12], the presence of disturbed sleep is likely to lead to poor outcomes and to complicate the management of LBP.…”

Section: Discussionmentioning

confidence: 64%

“…Other research suggests that improved sleep quality might reduce pain and daytime symptoms of patients with arthritis [16]. It is currently unclear how common sleep disturbance is for patients who are seeking care for their LBP, as estimates have been based on either highly selected groups of patients, such as the elderly or those attending specialist pain clinics [17][18][19], or small samples of chronic LBP patients [7,20,21]. These studies are likely to provide prevalence estimates that may not generalise to more heterogeneous samples of patients who are seeking care for their LBP.…”

Section: Introductionmentioning

confidence: 99%