Prevalence of sleep deprivation in patients with chronic neck and back pain: a retrospective evaluation of 1016 patients

Juraj Artner.¹ Balkan Cakir,¹ Jane-Anna Spiekermann,² Stephan Kurz,¹ Frank Leucht,¹ Heiko Reichel,¹ Friederike Lattig<sup>1

1</sup>Department of Orthopedic Surgery, ²Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany

Background: Chronic low back pain (CLBP) and chronic neck pain (CNP) have become a serious medical and socioeconomic problem in recent decades. Patients suffering from chronic pain seem to have a higher prevalence of sleep disorders.
Purpose: To calculate the prevalence of sleep deprivation in patients with CLBP and CNP and to evaluate the factors that may contribute to sleep impairment.
Methods: This study was a retrospective evaluation of 1016 patients with CNP and CLBP who consulted an orthopedic department at a university hospital. Factors assessed were gender, age, diagnosis, grade of sleep deprivation, pain intensity, chronification grade, and migrational background. Pearson's chi-squared test was performed to calculate the relationship between these factors and the grade of sleep deprivation. Regression analysis was performed to explore the correlation between the grade of sleep deprivation and age, pain intensity, and chronification grade.
Results: A high prevalence of sleep deprivation (42.22%) was calculated in patients with CNP and CLBP, even when analgesics had been taken. About 19.88% of the patients reported serious sleep impairments (ie, <4 hours of sleep per night). The grade of sleep deprivation did not correlate with the gender or age distribution. A significant relationship was found between the grade of sleep deprivation and pain intensity, failed back surgery syndrome, and patients with a migrational background. There was a moderate relationship with intervertebral disc disease and no relationship with spinal stenosis.
Conclusion: Sleep disturbance should be assessed when treating patients with CNP or CLBP, especially in patients with higher pain intensity, failed back surgery syndrome, and a migrational background. Further research is needed to explore the complex relationship of sleep disturbance and chronic pain.

Keywords: sleep disturbance, impairment, chronic low back pain, failed back surgery, disc disease, spinal stenosis, spondylolisthesis, migrational background, prevalence