When a patient begins care at my office, an important factor in my recommendations for the frequency of care, is if the symptoms interfere with their sleep. If symptoms interfere with sleep, I recommend frequent care in or der to improve the ability to sleep. If you can’t sleep, you can’t heal. ~ Dr. Broussard
Bidirectional Association Between Sleep Quality and Low Back Pain in Older Adults
Priscila K. Morelhão, PhD
Published: December 27, 2021
DOI:https://doi.org/10.1016/j.apmr.2021.11.009
Abstract
Objective
To investigate the bidirectional relationship by determining whether baseline sleep quality predicts pain intensity and whether baseline pain intensity predicts sleep quality in older individuals with chronic low back pain (LBP).
Design
A prospective longitudinal cohort study with a 6-month follow-up period.
Setting
Community.
Participants
Older adults with LBP aged 60 years or older (N=215).
Intervention
Not applicable.
Main Outcome Measures
Data collection occurred at baseline and at 6 months. Pain intensity and sleep quality were measured in both time points of assessment using the numeric pain rating scale (range, 0-10) and the Pittsburg Sleep Quality Index. At baseline, we also collected information on demographic anthropometric variables, cognitive status, depression, and comorbidities. Multivariable linear regression analyses adjusted for potential covariates were performed.
Results
A total of 215 individuals with LBP were recruited. Poor sleep quality at baseline predicted high pain intensity at 6 months (β coefficient, 0.18; 95% confidence interval [CI], 0.07-0.30). High pain intensity at baseline predicted poor sleep quality 6 months later (β coefficient, 0.14; 95% CI, 0.01-0.26).
Conclusion
Our findings give some support to the bidirectional relationship between pain and sleep quality in older individuals with LBP. This bidirectional relationship may be used as prognostic information by clinicians when managing patients with LBP.