School of Physiotherapy and Performance Science, Health Sciences, University College Dublin, Belfield, Dublin 4, Ireland.
BMC Musculoskelet Disord. 2009 Oct 2;10:122. doi: 10.1186/1471-2474-10-122.
While approximately 70% of chronic low back pain (CLBP) sufferers complain of sleep disturbance, current literature is based on self report measures which can be prone to bias and no objective data of sleep quality, based exclusively on CLBP are available. In accordance with the recommendations of The American Sleep Academy, when measuring sleep, both subjective and objective assessments should be considered as the two are only modestly correlated, suggesting that each modality assesses different aspects of an individual's sleep experience. Therefore, the purpose of this study was to expand previous research into sleep disturbance in CLBP by comparing objective and subjective sleep quality in participants with CLBP and healthy age and gender matched controls, to identify correlates of poor sleep and to test logistics and gather information prior to a larger study.
15 CLBP participants (mean age = 43.8 years (SD = 11.5), 53% female) and 15 healthy controls (mean age = 41.5 years (SD = 10.6), 53% female) consented. All participants completed the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Pittsburgh Sleep Diary and the SF36v2. CLBP participants also completed the Oswestry Disability Index. Sleep patterns were assessed over three consecutive nights using actigraphy. Total sleep time (TST), sleep efficiency (SE), sleep latency onset (SL) and number of awakenings after sleep onset (WASO) were derived. Statistical analysis was conducted using unrelated t-tests and Pearson's product moment correlation co-efficients.
CLBP participants demonstrated significantly poorer overall sleep both objectively and subjectively. They demonstrated lower actigraphic SE (p = .002) and increased WASO (p = .027) but no significant differences were found in TST (p = .43) or SL (p = .97). Subjectively, they reported increased insomnia (p =< .001), lower SE (p =< .001) and increased SL (p =< .001) but no difference between TST (p = .827) and WASO (p = .055). Statistically significant associations were found between low back pain (p = .021, r = -.589), physical health (p = .003, r = -.713), disability levels (p = .025, r = .576), and subjective sleep quality in the CLBP participants but not with actigraphy.
CLBP participants demonstrated poorer overall sleep, increased insomnia symptoms and less efficient sleep. Further investigation using a larger sample size and a longer period of sleep monitoring is ongoing.
尽管约 70%的慢性下背痛 (CLBP) 患者抱怨睡眠障碍，但目前的文献基于自我报告的测量方法，这些方法可能存在偏差，而且没有专门针对 CLBP 的客观睡眠质量数据。根据美国睡眠学院的建议，在测量睡眠时，应同时考虑主观和客观评估，因为两者相关性仅适中，表明每种方式评估个体睡眠体验的不同方面。因此，本研究的目的是通过比较 CLBP 患者和健康年龄和性别匹配的对照组的客观和主观睡眠质量，扩展 CLBP 睡眠障碍的先前研究，确定睡眠质量差的相关性，并在更大规模的研究之前进行后勤工作和收集信息。
15 名 CLBP 参与者（平均年龄=43.8 岁（SD=11.5），53%为女性）和 15 名健康对照组（平均年龄=41.5 岁（SD=10.6），53%为女性）同意参加。所有参与者都完成了匹兹堡睡眠质量指数、失眠严重程度指数、匹兹堡睡眠日记和 SF36v2。CLBP 参与者还完成了 Oswestry 残疾指数。使用活动记录仪连续三晚评估睡眠模式。从总睡眠时间 (TST)、睡眠效率 (SE)、睡眠潜伏期开始 (SL) 和睡眠后觉醒次数 (WASO) 中得出。使用独立 t 检验和 Pearson 积差相关系数进行统计分析。
CLBP 参与者在客观和主观上都表现出明显较差的整体睡眠。他们表现出较低的活动记录仪 SE（p=0.002）和增加的 WASO（p=0.027），但 TST（p=0.43）或 SL（p=0.97）没有显著差异。主观上，他们报告说失眠增加（p<0.001），SE 降低（p<0.001），SL 增加（p<0.001），但 TST（p=0.827）和 WASO（p=0.055）之间没有差异。在 CLBP 参与者中，与腰痛（p=0.021，r=-.589）、身体健康（p=0.003，r=-.713）、残疾水平（p=0.025，r=-.576）之间存在统计学显著关联，但与活动记录仪无关。
CLBP 参与者表现出整体睡眠较差、失眠症状增加和睡眠效率较低。使用更大的样本量和更长的睡眠监测时间正在进行进一步的调查。
