Sleep disturbances as predictors of hospitalization for back disorders-a 28-year follow-up of industrial employees

Spine (Phila Pa 1976). 2006 Jan 1;31(1):51-6. doi: 10.1097/01.brs.0000193902.45315.e5.


Study design: A prospective cohort study.

Objective: To study the relationship of sleep disturbances with severe back disorders leading to hospitalization.

Summary of background data: Sleep disturbances are associated with persistent pain syndromes, but little is known about their relationship with back disorders.

Methods: The first hospital admission for back disorders from 1973 to 2000 was studied in a cohort of metal industry workers (n = 902). The occurrence of sleep disturbances at baseline was categorized as: none; 1 type (either difficulties in falling asleep/waking up at night or nightmares); or both types. Cox proportional hazards regression was used to estimate the time between the assessment of risk factors and first hospital admission for back disorders.

Results: Those individuals who had 1 type of sleep disturbance had a 2.1-fold (95% confidence interval 1.1-3.8) risk of back-related hospitalization, and those with both types of disturbance a 2.4-fold (1.2-4.6) risk, compared with those with no sleep disturbances. The hazard ratios were 2.1; 1.0-4.6 and 2.9; 1.2-7.1, respectively, when patients with chronic back disease or recurrent back symptoms at baseline were excluded from the analyses.

Conclusion: These findings suggest that sleep disturbances are predictive of hospitalization for back disorders. The mechanism underlying this association warrants further study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Back Pain / complications*
  • Back Pain / epidemiology
  • Back Pain / psychology
  • Employment*
  • Female
  • Finland / epidemiology
  • Forecasting*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Occupational Health / statistics & numerical data*
  • Proportional Hazards Models
  • Prospective Studies
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / etiology*
  • Sleep Wake Disorders / psychology