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Less Pain, Better Sleep? The Effect of a Multidisciplinary Back Pain App on Sleep Quality in Individuals Suffering from Back Pain – a Secondary Analysis of App User Data

Authors Priebe JA, Utpadel-Fischler D, Toelle TR

Received 28 September 2019

Accepted for publication 27 April 2020

Published 20 May 2020 Volume 2020:13 Pages 1121—1128


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Robert B. Raffa

Janosch A Priebe, Daniel Utpadel-Fischler, Thomas R Toelle

Center of Interdisciplinary Pain Medicine, Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany

Correspondence: Janosch A Priebe
Center of Interdisciplinary Pain Medicine, Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Tel +49 89 4140 2563

Purpose: Mobile health solutions are finding their way into health systems. The Kaia app has been shown to be able to reduce back pain in two studies. Since pain often comes along with disturbed sleep and both symptoms are strongly related we investigated whether the Kaia app training is associated with improved sleep quality.
Methods: User data of individuals with back pain were collected in two app versions (cohort 1: N = 180; cohort 2: N = 159). We analyzed the ratings of sleep quality and pain intensity on a 11-point numeric ratings scale (NRS; 0– 10) both at the beginning of usage (baseline: BL) and on the individual last day of usage (follow-up: LU) within a 3-month training program.
Results: In both cohorts, we found a significant reduction in pain intensity from BL to LU (cohort 1: MBL = 4.80; SD = 1.59 to MLU = 3.75; SD = 1.76, Δpain = – 1.04; SD = 2.12; t(158) = 6.207; p<.001/cohort 2: MBL = 4.20; SD = 1.98 to MLU = 3.65; SD = 1.78; Δpain = – 0.50; SD = 2.04; t(147) = 3.001; p = 0.003) and a significant improvement of sleep quality (cohort 1: MBL = 5.76; SD = 2.12 to MLU = 6.56; SD = 1.72; Δsleep = t(158) = 4.310; p < 0.001/cohort 2: MBL = 6.08; SD = 2.08 to MLU = 6.76; SD = 1.55; Δsleep = 0.67; SD = 2.13; sleep: t(147) = 3.825; p < 0.001). Interestingly, improvement of sleep quality was not fully mediated by pain reduction.
Conclusion: Our analysis underlines the relationship between pain and sleep in the clinical context. Improvement of sleep quality came along with pain reduction and vice versa. Further study should explain the exact mechanisms of action which are associated with the improvement of both symptom parameters.

Keywords: back pain, sleep, mHealth, multidisciplinary pain treatment, app, self-management

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