The Association between Sleep and Chronic Spinal Pain: A Systematic Review from the Last Decade.

Eveline Van Looveren,Thomas Bilterys,Mira Meeus,Barbara Cagnie,Anneleen Malfliet,Liesbet De Baets,Wouter Munneke,Olivier Mairesse,Jo Nijs,Kelly Ickmans,Lieven Danneels,Maarten Moens,Dorien Goubert

doi:10.3390/jcm10173836

Abstract

Chronic spinal pain, including both neck and low back pain, is a common disabling disorder in which sleep problems are frequently reported as a comorbidity. The complex processes of both sleep and chronic pain seem to have overlapping mechanisms, which may explain their often established bidirectional relationship. This systematic review aims to investigate the assumed association between sleep and chronic spinal pain by providing an overview of the literature from the last decade. Eligible studies were obtained by searching four databases (PubMed, Embase, Web of Science, and PsycARTICLES). Articles were found relevant if they included a human adult population and investigated the possible association between sleep parameters and chronic spinal pain. Only studies published after January 2009 were included, as this review aimed to provide an update of a previous literature overview on this topic. The quality of the studies was assessed by risk of bias and level of evidence. A total of twenty-seven studies (6 cohort, 5 case-control, and 16 cross-sectional studies) were included in this systematic review. The methodological quality of these studies was low to moderate. The majority of studies reported weak to moderate evidence for an association between sleep parameters and chronic spinal pain, with more severe pain accompanied by more disturbed sleep. Addressing frequently reported sleep problems in chronic spinal pain patients therefore appears to be a necessary complement to pain management to achieve optimal treatment outcomes.

Highlights

Spinal pain consisting of both neck and low back pain is an ubiquitous disorder whereby a substantial number of patients develop recurrent or chronic complaints [1,2,3].The underlying pathophysiology of the chronic variant points in the direction of alterations in the central nervous system and involves psychological factors [4,5,6]
The remaining 2802 studies were screened by title and abstract and subsequently by full text, resulting in 27 eligible studies that were included in the qualitative synthesis
This study reported a strong correlation between the objective sleep parameters and pain intensity, suggesting that poorer sleep was associated with more severe pain in patients with chronic low back pain (CLBP) [42]

Summary

Introduction

Spinal pain consisting of both neck and low back pain is an ubiquitous disorder whereby a substantial number of patients develop recurrent or chronic complaints [1,2,3].The underlying pathophysiology of the chronic variant points in the direction of alterations in the central nervous system and involves psychological factors [4,5,6]. Spinal pain consisting of both neck and low back pain is an ubiquitous disorder whereby a substantial number of patients develop recurrent or chronic complaints [1,2,3]. Besides a major socio-economic impact on both the patient and society, the disabling character of chronic spinal pain (CSP) negatively affects quality of life parameters and sleep [7]. Insomnia disorder is defined as the patient’s dissatisfaction with the quality or quantity of his or her sleep, together with other symptoms manifesting during the day or night such as fatigue, mood disturbances, and cognitive complaints over the course of at least three nights a week for a period exceeding three months [23]

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Conclusion