Patients with Neck Pain are Less Likely to Improve if They Suffer from Poor Sleep Quality. A Prospective Study in Routine Practice

• Published in: The Clinical journal of pain
• Main Authors: Kovacs, Francisco M, Seco, Jesús, Royuela, Ana, Melis, Sergio, Sánchez, Carlos, Díaz-Arribas, María José, Meli, Marcelo, Núñez, Montserrat, Rodríguez, María Elena Martínez, Fernández, Carmen, Gestoso, Mario, Mufraggi, Nicole, Moyá, Jordi, Rodríguez-Pérez, Vicente, Torres-Unda, Jon, Burgos-Alonso, Natalia, Gago-Fernández, Inés, Abraira, Víctor
• Format: Journal Article
• Language: English
• Published: United States 28.08.2014
• ISSN: 1536-5409
• DOI: 10.1097/AJP.0000000000000147

To assess whether sleep quality (SQ) at baseline is associated with improvement in pain and disability at three months. 422 subacute and chronic patients with neck pain (NP) were recruited in 32 physiotherapy, primary care and specialized centers. NP, referred pain, disability, catastrophizing, depression and SQ were assessed through validated questionnaires, upon recruitment and 3 months later. Correlations between baseline scores were calculated through the Spearman's coefficient. Improvements in NP, disability and SQ were defined as a reduction≥30% of baseline score. Six estimative logistic regression models were developed to assess the association between baseline SQ and improvement of NP, baseline SQ and improvement of disability, baseline NP and improvement of SQ, baseline disability and improvement of SQ, the evolutions of NP and SQ, and the evolutions of disability and SQ. Most patients were subacute and mildly impaired. Regression models showed that: better SQ at baseline is associated with improvement of NP (OR [95%CI]=0.91 [0.83:0.99]), but not disability (1.04 [0.95;1.13]); the improvement of SQ is associated with more severe NP at baseline (1.26 [1.07;1.49)], but not with baseline disability (0.99 [0.97;1.02]); and that improvement in SQ is associated with improvements in NP (3.48 [1.68; 7.20]), and disability (5.02 [2.39;10,11]). Neck pain is less likely to improve in patients with poorer sleep quality, irrespective of age, sex, catastrophizing, depression or treatments prescribed for NP. Future studies should confirm these results with more severely impaired patients.