INTRODUCTION: Sleep disturbance is one of the symptoms in patients with chronic pain syndrome. It has been reported that the severity of pain is related to sleep length and quality. There were few reports about the relationship between neurological symptoms, including low back pain and sleep disturbance in patients with degenerative lumbar diseases. The purpose of this study was to elucidate the prevalence of sleep disturbance in patients with degenerative lumbar diseases and to analyze its related factors.

METHODS: In our institution, this study included eighty-four patients (male: 52, female: 32, average age: 68.5 years) who received surgical treatment for degenerative lumbar diseases from July 2019 to September 2020. There were 12 patients with lumbar disc herniation, 44 patients with lumbar canal stenosis, 16 patients with spondylolisthesis, and 12 patients with other diseases. Clinical symptoms (low back pain VAS, leg pain VAS, and numbness in the lower extremity), health-related QOL (EQ-5D), low back pain associated QOL (ODI and RDQ), and central sensitivity index (CSI) were evaluated preoperatively. Sleep disturbance was assessed by MOS 12-Item Sleep Scale in which Sleeping Time (ST), Sleep Quality (SQ), and Somnolence (SL) were used in this study. Correlation between these three outcome measures in MOS 12-Item Sleep Scale and preoperative clinical parameters were statistically assessed, and the factors affecting sleep disturbance were evaluated using multiple regression analysis.

RESULTS: Average sleeping time of subjects was 6.2 hours in this study cohort. There was no significant difference in ST, SQ, SL by gender and lumbar diseases. ST was significantly correlated with CSI (P<0.05). SQ was correlated significantly with EQ-5D, CSI, leg VAS (P<0.01), and low back pain VAS, ODI, RDQ (P<0.05). SL has a significant correlation with EQ-5D, CSI, low back pain VAS, ODI, RDQ (P<0.01). Multiple regression analysis revealed that ST was significantly associated with RDQ, CSI, and EQ-5D. SQ was significantly associated with CSI and age, SL with CSI.

DISCUSSION: The results of this study revealed that sleep disturbance was correlated with the extent of neurological symptoms, health-related QOL, and central sensitization, and most significantly associated with the central sensitization evaluated by CSI.