Kovacs Back Pain Unit, HLA-Moncloa University Hospital, Madrid, Spain.
Spanish Back Pain Research Network, Palma de Mallorca, Spain.
Eur J Pain. 2018 Jan;22(1):114-126. doi: 10.1002/ejp.1095. Epub 2017 Aug 27.
The objective of this study was to estimate the association between sleep quality (SQ) and improvements in low back pain (LBP) and disability, among patients treated for LBP in routine practice.
This prospective cohort study included 461 subacute and chronic LBP patients treated in 11 specialized centres, 14 primary care centres and eight physical therapy practices across 12 Spanish regions. LBP, leg pain, disability, catastrophizing, depression and SQ were assessed through validated questionnaires upon recruitment and 3 months later. Logistic regression models were developed to assess: (1) the association between the baseline score for SQ and improvements in LBP and disability at 3 months, and (2) the association between improvement in SQ and improvements in LBP and disability during the follow-up period.
Seventy-three per cent of patients were subacute. Median scores at baseline were four points for both pain and disability, as assessed with a visual analog scale and the Roland-Morris Questionnaire, respectively. Regression models showed (OR [95% CI]) that baseline SQ was not associated with improvements in LBP (0.99 [0.94; 1.06]) or in disability (0.99 [0.93; 1.05]), although associations existed between 'improvement in SQ' and 'improvement in LBP' (4.34 [2.21; 8.51]), and 'improvement in SQ' and 'improvement in disability' (4.60 [2.29; 9.27]).
Improvement in SQ is associated with improvements in LBP and in disability at 3-month follow-up, suggesting that they may reflect or be influenced by common factors. However, baseline SQ does not predict improvements in pain or disability.
In clinical practice, sleep quality, low back pain and disability are associated. However, sleep quality at baseline does not predict improvement in pain and disability.
本研究旨在评估睡眠质量（SQ）与接受常规治疗的腰痛（LBP）患者的疼痛改善和残疾改善之间的关联。
这项前瞻性队列研究纳入了 12 个西班牙地区的 11 个专门中心、14 个初级保健中心和 8 个物理治疗诊所的 461 名亚急性和慢性 LBP 患者。在招募时和 3 个月后，通过经过验证的问卷评估 LBP、腿部疼痛、残疾、灾难化、抑郁和 SQ。采用逻辑回归模型评估：（1）SQ 基线评分与 3 个月时 LBP 和残疾改善之间的关联；（2）SQ 改善与随访期间 LBP 和残疾改善之间的关联。
73%的患者为亚急性。疼痛和残疾的基线中位数评分分别为视觉模拟评分（VAS）和 Roland-Morris 问卷（RMDQ）的 4 分。回归模型显示（OR [95%CI]），SQ 基线与 LBP（0.99 [0.94; 1.06]）或残疾（0.99 [0.93; 1.05]）的改善无关，但“SQ 改善”与“LBP 改善”（4.34 [2.21; 8.51]）和“SQ 改善”与“残疾改善”（4.60 [2.29; 9.27]）之间存在关联。
SQ 的改善与 3 个月随访时 LBP 和残疾的改善相关，这表明它们可能反映或受共同因素的影响。然而，SQ 基线并不能预测疼痛或残疾的改善。
在临床实践中，睡眠质量、腰痛和残疾是相关的。然而，基线睡眠质量并不能预测疼痛和残疾的改善。
