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  • PMID: 25171635 was deleted because it is a duplicate of PMID: 26153781
Clin J Pain. 2015 Aug;31(8):713-21. doi: 10.1097/AJP.0000000000000147.

Patients with neck pain are less likely to improve if they experience poor sleep quality: a prospective study in routine practice.

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*Departamento Científico †Spanish Back Pain Research Network, Fundación Kovacs ‡‡IBaD Clínica del Dolor-Majorca Spine and Pain Clinic ¶¶Centro Salud Arquitecto Bennassar ##Unidad de la Espalda Kovacs, Hospital de Cruz Roja Española, Palma de Mallorca #Centro de Fisioterapia Sergio Melis/Ronda Oeste, Mallorca ‡Institute of Biomedicine (IBIOMED), University of León ‡‡‡Departamento de Fisiología, Universidad de El País Vasco (UPV/EHU), Campus Universitario, Guipúzcoa §University of the Basque Country, Campus Universitario, Basque Country †††Escuela Universitaria Ciencias de la Salud, Universidad de León, Campus Universitario, Ponferrada, León ∥CIBER Epidemiología y Salud Pública (CIBERESP) §§Servicio de Reumatología, Hospital Clínic, Barcelona ¶Unidad de Bioestadística Clínica ∥∥Sección de Rehabilitación Reumatológica, Hospital Ramón y Cajal, IRICYS ††Physical Medicine and Rehabilitation Department, Faculty of Medicine, Complutense University, Madrid **Fisys Fisioterapia, Cantabria ***Unidad del Dolor, Hospital Mateu Orfila, Mahón §§§Departamento de Medicina Preventiva y Salud Pública, Universidad de El País Vasco (UPV/EHU), Campus Universitario, Vizcaya, Spain.



To assess whether sleep quality (SQ) at baseline is associated with improvement in pain and disability at 3 months.


Four hundred twenty-two 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 coefficient. Improvements in NP, disability, and SQ were defined as a reduction of ≥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 was associated with improvement of NP (odds ratio=0.91 [95% confidence interval, 0.83-0.99]), but not disability (1.04 [0.95-1.13]); the improvement of SQ was 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 was associated with improvements in NP (3.48 [1.68-7.20]), and disability (5.02 [2.39-10.11]).


NP is less likely to improve in patients with poorer SQ, irrespective of age, sex, catastrophizing, depression, or treatments prescribed for NP. Future studies should confirm these results with more severely impaired patients.

[Indexed for MEDLINE]

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