Do Magnetic Resonance Imaging Characteristics of Full-Thickness Rotator Cuff Tears Correlate With Sleep Disturbance?

Orthop J Sports Med. 2017 Nov 1;5(11):2325967117735319. doi: 10.1177/2325967117735319. eCollection 2017 Nov.


Background: Many patients with rotator cuff tears suffer from nocturnal shoulder pain, resulting in sleep disturbance.

Purpose: To determine whether rotator cuff tear size correlated with sleep disturbance in patients with full-thickness rotator cuff tears.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Patients with a diagnosis of unilateral full-thickness rotator cuff tears (diagnosed via magnetic resonance imaging [MRI]) completed the Pittsburgh Sleep Quality Index (PSQI), a visual analog scale (VAS) quantifying their shoulder pain, and the American Shoulder and Elbow Surgeons (ASES) questionnaire. Shoulder MRI scans were analyzed for anterior-posterior tear size (mm), tendon retraction (mm), Goutallier grade (0-4), number of tendons involved (1-4), muscle atrophy (none, mild, moderate, or severe), and humeral head rise (present or absent). Bivariate correlations were calculated between the MRI characteristics and baseline survey results.

Results: A total of 209 patients with unilateral full-thickness rotator cuff tears were included in this study: 112 (54%) female and 97 (46%) male (mean age, 64.1 years). On average, shoulder pain had been present for 24 months. The mean PSQI score was 9.8, and the mean VAS score was 5.0. No significant correlations were found between any of the rotator cuff tear characteristics and sleep quality. Only tendon retraction had a significant correlation with pain.

Conclusion: Although rotator cuff tears are frequently associated with nocturnal pain and sleep disruption, this study demonstrated that morphological characteristics of full-thickness rotator cuff tears, such as size and tendon retraction, do not correlate with sleep disturbance and have little to no correlation with pain levels.

Keywords: MRI; patient-reported outcome measures; rotator cuff tear; rotator cuff tear pattern; shoulder pain; sleep quality.