Insomnia in patient with chronic low back pain

2017 
Objective Chronic low back pain (CLBP) is the most common complaint in rehabilitation system and it is associated with reduced quality of life, limitation of function, high economic costs for health service system and it is almost universally associated with sleep disturbance. It was considered that insomnia was a symptom of pain conditions and of little consequence in its’ own right, new studies suggest that insomnia has important effects on the clinical course of pain syndromes. While pain may disrupt sleep, it appears that problems with sleep increase pain and are associated with impairments in daytime function. The emerging point of view is that specific treatment for both pain and insomnia is needed for optimal clinical management. The aim of the study was to assess insomnia of patients with low back pain and to identify factors associated with this insomnia. Clinical insomnia among CLBP patients’ requires a well standardized and adjusted treatment in the aim of increasing the quality of life. Material/Patients and methods The study included 45 patients suffering from low back pain (24 women, 21 males, mean age: 54.15 ± 7.8 years). Insomnia severity was assessed using Index of Severity of Insomnia with a global score going from 0 (the best situation) to 28 (the worst situation). Relationship between insomnia and low back pain was analyzed. In literature, CLBP is associated with greater sleep disturbance: sleep disturbance and duration, sleep quality, the ability to fall asleep and sleep distress. All these criteria were investigated during the study. Results Insomnia was reported by 43% of patients and was caused by pain in 82% of them. Insomnia was early, middle and late in respectively 55.32 and 13% fall insomniac patients. Consequences of insomnia were followed by daily activities disturbance, tiredness and mood disorders. Significant correlations were found between index of severity of insomnia and pain (VAS) and body mass index ( P Discussion/Conclusion Assessment of insomnia must be integrated in chronic low back pain management. Management strategies for CLBP need to take into consideration all complications that this pathology involves in order to increase the quality of life for these patients.
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