Sleep disturbance in patients with chronic low back pain

Am J Phys Med Rehabil. 2006 May;85(5):430-5. doi: 10.1097/01.phm.0000214259.06380.79.


Objective: To document the relationship between sleep disturbance and chronic low back pain in patients referred to a physical medicine and rehabilitation clinic.

Design: This is a prospective cross-sectional survey of 268 patients 18 yrs or older being evaluated for low back pain of greater than 6 months at a tertiary medical center. The survey consisted of a 43-item composite form that contained the Short-Form McGill Pain Questionnaire (SF-MPQ); the Pittsburgh Sleep Quality Index (PSQI); a pain visual analog scale (VAS); and questions regarding bed type, sleep position, and patients' sleep description.

Results: There was a significant relationship between pain and sleep (P<0.0005) with a 55% increase in the proportion of subjects reporting restless/light sleep after pain onset. There was no corresponding increase in sleep medication use. There was a significant direct correlation between SF-MPQ and PSQI (r=0.44, P<0.0005); between PSQI and VAS (r=0.41, P<0.0005); and between overall quality of sleep and VAS (r=0.31, P<0.0005). Finally, PSQI scores were the worst in subjects sleeping on an orthopedic mattress (P=0.001).

Conclusions: Chronic low back pain significantly affects quality of sleep. Sleep problems should be addressed as an integral part of the pain management plan.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Beds / classification
  • Beds / statistics & numerical data
  • Causality
  • Chronic Disease
  • Comorbidity
  • Cross-Sectional Studies
  • District of Columbia / epidemiology
  • Female
  • Humans
  • Low Back Pain / diagnosis
  • Low Back Pain / epidemiology*
  • Male
  • Middle Aged
  • Pain Measurement
  • Prevalence
  • Prospective Studies
  • Sex Distribution
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / epidemiology*