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J Orthop Surg (Hong Kong). 2013 Apr;21(1):68-70.

Prevalence of insomnia in patients with chronic back pain.

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Spinal Unit, University Hospital of North Tees, Stockton on Tees, United Kingdom.



To estimate the prevalence of insomnia in patients with chronic back pain, and to correlate insomnia with severity of back pain and disability.


63 women and 57 men aged 24 to 83 (mean, 55) years who presented with chronic back pain for >6 months were asked to complete a self-administered questionnaire to evaluate the Insomnia Severity Index (ISI), Oswestry Disability Index (ODI), and Numerical Rating Scale (NRS) for back pain.


Of the 120 patients, 25 had no insomnia, 39 had sub-threshold insomnia, and 56 had clinically significant insomnia. According to the ODI, disability was minimal in 12 patients, moderate in 38, severe in 43, bed-binding in 26, and crippling in one. Of the 120 patients, 91 rated their NRS for back pain as 5 to 10 and 29 rated it as 1 to 4. Correlation was stronger between ISI and ODI than between ISI and NRS for back pain (r=0.59 vs. r=0.38).


47% of patients with chronic back pain had insomnia. The ODI was more reliable than the NRS for back pain to detect insomnia. Back pain should be treated early to avoid serious health problems associated with insomnia.


back pain; sleep initiation and maintenance disorders

[Indexed for MEDLINE]

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