Article

OBJECTIVE: To characterize sleep and its relationship with disability and pain in
patients with spine pathology. DESIGN: A survey study. SETTING: A
university-based hospital spine clinic. PARTICIPANTS: Subjects (N=121) with
mixed-etiology spine pathology. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: Self-reported disability (Oswestry Disability Index [ODI]), back and
leg pain intensity, the effect of back or leg pain on function, and sleep
(Pittsburgh Sleep Quality Index [PSQI]) assessments were completed. RESULTS:
Severe disability was evident with a mean ODI +/- SD of 54.9+/-14, with mean pain
intensities +/- SD of 50+/-30 mm and 54+/-27 mm of 100mm for the leg and back,
respectively. The mean PSQI +/- SD was 10.4+/-5.3, with 87% of participants
scoring greater than the sleep-disordered threshold of 5. PSQI was correlated to
ODI (r=.53, P<.001), and ODI without the sleep component (r=.47, P<.001). Six of
the subscales of PSQI were all also significantly correlated to ODI (.25<r<.42,
P<.05). Stepwise regression (ODI dependent variables; PSQI, pain intensity and
function, age, body mass index as independent variables) was performed. PSQI was
retained in the model along with 2 pain measures (r(2)=.50, P<.001). Substitution
of the 7 subscales for the overall PSQI score revealed 2 subscales (sleep
quality, use of sleep medications) as predictors of ODI (r(2)=.490, P<.001).
CONCLUSIONS: Despite its being intuitive that sleep disorders will be present in
patients with spinal disorders, it was surprising that sleep quality was an
independent predictor of disability along with pain. Furthermore, sleep quality
is more closely correlated to disability than leg pain, which is the current
focus of medical interventions.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS