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Sleep Disturbance in Patients With Chronic Low Back Pain

Marin, Raul MD; Cyhan, Tamara RN, BSN; Miklos, Wendy MD

American Journal of Physical Medicine & Rehabilitation: May 2006 - Volume 85 - Issue 5 - p 430-435
doi: 10.1097/01.phm.0000214259.06380.79
Research Article: Back Pain
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Marin R, Cyhan T, Miklos W: Sleep disturbance in patients with chronic low back pain. Am J Phys Med Rehabil 2006;85:430–435.

Objective: To document the relationship between sleep disturbance and chronic low back pain in patients referred to a physical medicine and rehabilitation clinic.

Design: This is a prospective cross-sectional survey of 268 patients 18 yrs or older being evaluated for low back pain of greater than 6 months at a tertiary medical center. The survey consisted of a 43-item composite form that contained the Short-Form McGill Pain Questionnaire (SF-MPQ); the Pittsburgh Sleep Quality Index (PSQI); a pain visual analog scale (VAS); and questions regarding bed type, sleep position, and patients' sleep description.

Results: There was a significant relationship between pain and sleep (P < 0.0005) with a 55% increase in the proportion of subjects reporting restless/light sleep after pain onset. There was no corresponding increase in sleep medication use. There was a significant direct correlation between SF-MPQ and PSQI (r = 0.44, P < 0.0005); between PSQI and VAS (r = 0.41, P < 0.0005); and between overall quality of sleep and VAS (r = 0.31, P < 0.0005). Finally, PSQI scores were the worst in subjects sleeping on an orthopedic mattress (P = 0.001).

Conclusions: Chronic low back pain significantly affects quality of sleep. Sleep problems should be addressed as an integral part of the pain management plan.

From the Physical Medicine & Rehabilitation Service, Department of Orthopedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC.

All correspondence should be addressed to COL Raul Marin, MD, 20009 Manor View Terrace, Laytonsville, MD 20307.

The opinions and assertions contained here are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the U.S. government.

© 2006 Lippincott Williams & Wilkins, Inc.