Marin Raul, Cyhan Tamara, Miklos Wendy
Physical Medicine & Rehabilitation Service, Department of Orthopedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC, USA.
Am J Phys Med Rehabil. 2006 May;85(5):430-5. doi: 10.1097/01.phm.0000214259.06380.79.
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.
记录转至物理医学与康复诊所的患者睡眠障碍与慢性下腰痛之间的关系。
这是一项对268名18岁及以上患者进行的前瞻性横断面调查，这些患者在一家三级医疗中心接受超过6个月的下腰痛评估。该调查包括一份43项的综合表格，其中包含简短麦吉尔疼痛问卷（SF-MPQ）、匹兹堡睡眠质量指数（PSQI）、疼痛视觉模拟量表（VAS）以及有关床型、睡眠姿势和患者睡眠描述的问题。
疼痛与睡眠之间存在显著关系（P<0.0005），疼痛发作后报告不安稳/浅睡眠的受试者比例增加了55%。睡眠药物的使用没有相应增加。SF-MPQ与PSQI之间存在显著正相关（r=0.44，P<0.0005）；PSQI与VAS之间存在显著正相关（r=0.41，P<0.0005）；睡眠总体质量与VAS之间存在显著正相关（r=0.31，P<0.0005）。最后，睡矫形床垫的受试者PSQI得分最差（P=0.001）。
慢性下腰痛显著影响睡眠质量。睡眠问题应作为疼痛管理计划的一个组成部分加以解决。
