Prevalence and severity of insomnia in chronic low back pain patients

Abstract

The purpose of this study was to assess prevalence and severity of insomnia in participants diagnosed with chronic low back pain (CLBP) and to identify factors associated with this insomnia. One hundred CLBP consenting participants were recruited. Sociodemographic, CLBP features and sleep characteristics were collected. Patients answered validated measures of insomnia severity and fatigue. Statistical analysis examined the relationship between insomnia, sociodemographic characteristics of patients and CLBP parameters. Seventy-eight percent of patients suffered from insomnia. Insomnia due to back pain was reported in 64 % of cases. Insomnia was early, middle and late in, respectively, 39, 60 and 41 % of patients. Insomnia was sub-threshold, moderate and severe in, respectively, 34, 42 and 2 % of patients. ISI Global score was at 18.07 ± 7.3. ISI correlated significantly with pain intensity (r = 0.587; p < 0.0001), fatigue level (r = 0.495; p < 0.0001) and body mass index (r = -0.209; p = 0.03). Multiple linear regression models have revealed that pain intensity (β = 1.984; 95 % CI (1.517-2.451); p < 0.0001) and fatigue (β = 0.284; 95 % CI (0.192-0.377); p < 0.0001) were the strongest determinants for predicting insomnia in CLBP patients. Our study suggests that the prevalence of insomnia is important in CLBP patients, occurring especially at the middle of sleep. Insomnia was essentially sub-threshold or moderate. Back pain and fatigue experienced by patients were the strongest factors associated with this insomnia.

Sleep Quality, Quality of Life and Insomnia Among Patients with Chronic Low Back Pain Compared to Normal Individuals

“…Pain with any origin is only one of them. Similarly, Bahoug and his coworkers has found also moderate correlation between the pain severity and insomnia (Bahouq et al, 2013).…”

“…Sixty four million of Americans suffer from inadequate sleep according to report of the health ministry of USA. This is 1.4 time more prevalent in women (Basics 2011;Lamberg 2007 (Alsaadi, McAuley, Hush, & Maher 2011;Bahouq, Allali, Rkain, Hmamouchi, Hajjaj-Hassouni 2013). Pain and sleep may have intricate relationship with each other.…”

Pain-related Sleep Disturbance

“…13 Several studies have examined the association of pain and sleep disturbance and have found evidence of associations of pain with sleep quality, 11,14 reduced sleep time, 12 lower sleep efficiency, 9,11 and more awakenings. 11 All of these studies examine chronic pain, thus the relationship between acute pain and sleep disturbance is less well examined.…”

“…[8][9][10] Thus, it is a substantial problem "adding insult to injury" for this large group of patients, perhaps contributing to a vicious cycle of maintaining pain. There is a need to understand the association of pain and sleep to improve the management of LBP.…”

“…4,5 Further, the pain has been shown to affect mood and well-being. 6 Concomitant depression and anxiety, 6 poorer quality of life, 7 and disturbed sleep [8][9][10] are found in populations of patients with LBP.…”