INTRODUCTION: Sleep disturbance is one of symptoms in patients with chronic pain syndrome. It has been reported that the amount of pain is related to sleep length and quality. There were few reports about the relationship between clinical symptoms and sleep disturbance in patients with degenerative spine diseases. The purpose of this study was to elucidate the prevalence of sleep disturbance in patients with degenerative spine diseases and to analyze the related factors that associated with sleep disturbance.
METHODS: One hundred and seven patients (male: 62, female: 45, average age: 66.1 years) who received surgical treatment for degenerative spine diseases from April 2020 to December 2021 in our institution were included in this study. There were 35 patients with cervical spine diseases and 68 patients with lumbar spine diseases. Preoperative clinical outcome assessment (COAs) including Visual Analogue Scale (VAS) of pain and numbness, health related QOL (EQ-5D), low back pain related QOL (ODI and RDQ), and central sensitivity index (CSI) were evaluated. Sleep disturbance was assessed by MOS 12-Item Sleep Scale which comprises difficulty of falling asleep (DFA), sleep somnolence (SS), sleep adequacy (SA), sleeping time (ST) and sleep problem index (SPI-2). The degree of sleep disturbance was statistically investigated in the entire patient population and the comparison between cervical and lumbar spine diseases. The correlation between sleep disturbance and preoperative COAs was statistically analyzed.
RESULTS: The scores of each subscale in the entire patient population were DFA: 35, SS: 42, SA: 48, ST: 6, SPI-2: 36. There were no significant differences in each subscale between cervical and lumbar spine diseases (DFA: 40/32, SS: 41/43, SA: 50/47, ST: 6/6, SPI-2: 39/35).
Females had a significantly higher in the SPI-2 than males (P<0.05), and there was a moderate correlation between age and SA in the patients with cervical spine diseases. VAS of neck pain showed a moderate correlation with SA and SPI-2, and VAS of low back pain and lower extremity pain showed a weak correlation with SS. In the EQ5D and CSI of the entire patient population, and in the ODI of the patients with lumbar spine diseases, there was a weak to moderate correlation with each subscale except for ST.
DISCUSSION: The results of this study revealed that neck pain in the patients with cervical spine diseases had a strong correlation with sleep adequacy (SA), and low back pain and lower limb pain in the patients with lumbar spine diseases had a weak correlation with sleep somnolence (SS). Among each subscale item for sleep disorders, except sleeping time (ST) had a statistically significant correlation with EQ5D, ODI, and CSI.