Sleep Disturbance in Patients With Chronic Low Back Pain : American Journal of Physical Medicine & Rehabilitation

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Research Article: Back Pain

Sleep Disturbance in Patients With Chronic Low Back Pain

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

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American Journal of Physical Medicine & Rehabilitation 85(5):p 430-435, May 2006. | DOI: 10.1097/01.phm.0000214259.06380.79


Marin R, Cyhan T, Miklos W: Sleep disturbance in patients with chronic low back pain. Am J Phys Med Rehabil 2006;85:430–435.


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


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.


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).


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

© 2006 Lippincott Williams & Wilkins, Inc.

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