Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain

Abstract

Study design: A cross-sectional descriptive study of self-reported quality of sleep in individuals with a spinal cord injury (SCI). Objectives: To assess and describe subjective quality of sleep in patients with SCI, with and without pain. Setting: Spinalis SCI unit, Stockholm, Sweden. Methods: A total of 230 patients with an SCI were mailed a questionnaire containing queries about pain intensities, pain unpleasantness, mood, and sleep quality (Basic Nordic Sleep Questionnaire) to assess quality of sleep in patients with SCI with and without pain. Results: Of the 192 questionnaires that were returned (response rate 83.4%), 191 were analysed. Patients were divided into three groups: (1) those who reported no pain (n ¼ 50), (2) those who reported intermittent pain (n ¼ 42), and (3) those who suffered from continuous pain (n ¼ 99). Patients suffering from continuous pain rated pain intensity and unpleasantness significantly higher than those who only suffered from intermittent pain. The group with continuous pain also reported the poorest quality of sleep and the highest ratings of anxiety and depression of the three groups. Anxiety, together with pain intensity and depression, were the main predictors for poor sleep quality. Conclusions: Poor subjective sleep quality was associated with higher ratings of pain intensity, anxiety, and depression. It is possible that melatonin serves as a modulator of these different aspects. Sponsorship: This study was made possible by grants from Spinalis Foundation.Spinal Cord (2005) 43, 85-95.

Psychosocial aspects of spinal cord injury pain: a meta-analysis

“…This included six studies with overlapping samples, or two studies each by Norrbrink Budh et al, 24 Norrbrink Budh and Osteraker, 25 Putzke et al 26,27 and Rintala et al 28,29 However, only the single studies from Norrbrink Budh et al 24 and Putzke et al 26 met the minimum inclusion criteria, whereas the phase 1 data from Rintala et al 29 was used as it comprised a larger sample size. This resulted in a final sample of 16 independent studies.…”

“…This resulted in a final sample of 16 independent studies. 11,18,24,26,[29][30][31][32][33][34][35][36][37][38][39][40] Data extraction and organisation…”

“…no pain vs intermittent or continuous pain). 24,29,35 The data for each study was therefore pooled to reflect two distinct and consistent groups: SCI pain and SCI no pain. Similarly, where data were provided separately for subgroups (i.e.…”

Effects of chronic pain on quality of life and depression in patients with spinal cord injury

“…3 Although the pain often starts within the initial 6 months of SCI, it frequently persists and sometimes can even become aggravated over time. 4 As pain is known to affect recreational activities and vocational status, 5 quality of sleep 6 and sexuality, 7 it can have a major role in QoL, mood and rehabilitation outcome. For many of them, the pain is severe and accompanied by reduced physical functioning, eventually lowering the QoL.…”

Prevalence of depression, fatigue, and sleep disturbances in patients with myelopathy: Their relation with functional and neurological recovery

“…5 Patients with myelopathies commonly have excessive daytime sleepiness and disturbed sleep, including reduced rapid eye movement (REM) sleep, increased need for sleep medications, snoring, and sleep-apnea syndrome. [6][7][8] Sleep disturbances such as sleep disordered breathing or obstructive sleep-apnea syndrome occur in 40-45% of patients. 9 With increasing survival of myelopathy patients due to better medical and surgical management in the initial stages, prevalence of these conditions is set to increase.…”