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Clin J Pain. 2014 Aug 28. [Epub ahead of print]

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

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  • 1*Departamento Científico. Fundación Kovacs. Paseo Mallorca 36, 07012 Palma de Mallorca, Spain †Spanish Back Pain Research Network ‡Institute of Biomedicine (IBIOMED). University of León, Spain. Visiting Researcher. University of the Basque Country, Spain. Campus Universitario. 24071 León (Spain) §CIBER Epidemiología y Salud Pública (CIBERESP). Spain ∥Unidad de Bioestadística Clínica. Hospital Ramón y Cajal. IRICYS. Ctra. de Colmenar Viejo km. 9,100. 28034 Madrid. Spain ¶Centro de Fisioterapia Sergio Melis/Ronda Oeste, 97, 07680 Porto Cristo (Mallorca). Spain #Fisys Fisioterapia. Eguilior, 18. 39770 Laredo (Cantabria) **Physical Medicine and Rehabilitation Department, Faculty of Medicine, Complutense University. 28040 Madrid, Spain ††IBaD Clínica del Dolor-Majorca Spine and Pain Clinic. C/31 de Diciembre,12. 07004 Palma de Mallorca, Spain ‡‡Servicio de Reumatología. Hospital Clínic. C/Villarroel, 170. 08036 Barcelona, Spain §§Sección de Rehabilitación Reumatológica. Hospital Ramón y Cajal. IRICYS. Ctra. de Colmenar Viejo km. 9,100. 28034 Madrid. Spain ∥∥Centro Salud Arquitecto Bennassar. Av. Arquitecto Gaspar Bennasar, 9 07004 Palma de Mallorca. Spain ¶¶Unidad de la Espalda Kovacs. Hospital de Cruz Roja Española. C/Pons y Gallarza, 90. 07004 Palma de Mallorca, Spain ##Unidad del Dolor. Hospital Mateu Orfila. Ronda de Malbúrge, 1. 07703 Mahón. Spain ***Escuela Universitaria Ciencias de la Salud. Universidad de León. Campus Universitario, Avda. Astorga s/n 24400. Ponferrada (Spain) †††Departamento de Fisiología, Universidad de El País Vasco (UPV/EHU), Campus Universitario. B° Sarriena s/n 48940, Leioa, Vizcaya. (Spain) ‡‡‡Departamento de Medicina Preventiva y Salud Pública, Universidad de El País Vasco (UPV/EHU), Campus Universitario. B° Sarriena s/n 48940, Leioa, Vizcaya (Spain).

Abstract

OBJECTIVE::

To assess whether sleep quality (SQ) at baseline is associated with improvement in pain and disability at three months.

METHODS::

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.

RESULTS::

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]).

DISCUSSION::

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.

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