Relationship, differences, and agreement between objective and subjective sleep measures in chronic spinal pain patients with comorbid insomnia: a cross-sectional study : PAIN

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Relationship, differences, and agreement between objective and subjective sleep measures in chronic spinal pain patients with comorbid insomnia: a cross-sectional study

Bilterys, Thomasa,b,c,*; Van Looveren, Evelinea,b,c; Malfliet, Anneleena,c,d,e; Nijs, Joa,c,d,f; Meeus, Mirab,c,g; Danneels, Lievenb; Ickmans, Kellya,c,d,h; Cagnie, Barbarab; Goubert, Dorienb; Moens, Maartenc,i,j,k; De Baets, Liesbeta,c; Munneke, Woutera,c; Mairesse, Olivierl,m

Author Information

aPain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium

bDepartment of Rehabilitation Sciences, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium

cPain in Motion International Research Group

dDepartment of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium

eResearch Foundation Flanders (FWO), Brussels, Belgium

fDepartment of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden

gDepartment of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

hMovement & Nutrition for Health & Performance Research Group (MOVE), Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium

iDepartment of Neurosurgery and Radiology, University Hospital Brussels, Brussels, Belgium

jCenter for Neuroscience, Vrije Universiteit Brussel, Brussels, Belgium

kStimulus Research Group, Vrije Universiteit Brussel, Brussels, Belgium

lBrain, Body and Cognition, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium

mSleep Laboratory and Unit for Clinical Chronobiology, Brugmann University Hospital, Brussels, Belgium

*Corresponding author. Address: Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium. E-mail address: [email protected] (T. Bilterys).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

PAIN 164(9):p 2016-2028, September 2023. | DOI: 10.1097/j.pain.0000000000002901

Sleep disturbances are one of the most frequent reported problems in people with nonspecific chronic spinal pain (nCSP) and presents an additional treatment challenge. Interventions targeting sleep problems are mainly based on subjective sleep complaints and do not take objective sleep into consideration. The aim of this cross-sectional study was to evaluate the relationship and conformity between self-reported and objectively measured sleep parameters (ie, questionnaire vs polysomnography and actigraphy). The baseline data of 123 people with nCSP and comorbid insomnia who are participating in a randomized controlled trial were analyzed. Pearson correlations were used to investigate the relationship between objective and subjective sleep parameters. Differences between objective and subjective sleep parameters were analyzed using t tests. Bland–Altman analyses were performed to quantify and visualize agreement between the different measurement methods. Except for the significant moderate correlation between perceived time in bed (TIB) and actigraphic TIB (r = 0.667, P < 0.001), all other associations between subjective and objective measures were rather weak (r < 0.400). Participants underestimated their total sleep time (TST) (mean difference [MD] = −52.37 [−67.94, −36.81], P < 0.001) and overestimated sleep onset latency (SOL) (MD = 13.76 [8.33, 19.20], P < 0.001) in general. The results of this study suggest a discrepancy (differences and lack of agreement) between subjective and objective sleep parameters in people with nCSP and comorbid insomnia. No or weak associations were found between self-reported sleep and objectively measured sleep. Findings suggest that people with nCSP and comorbid insomnia tend to underestimate TST and overestimate SOL. Future studies are necessary to confirm our results.

© 2023 International Association for the Study of Pain

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