• Clinical spine surgery · May 2020

    Sleep Disturbance in Patients With Lumbar Spinal Stenosis: Association With Disability and Quality of Life.

    • Na-Kyoung Lee, Seung Won Jeon, Young Woo Heo, Feng Shen, Ho-Joong Kim, In-Young Yoon, Bong-Soon Chang, Choon-Ki Lee, Heoung-Jae Chun, and Jin S Yeom.
    • Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital.
    • Clin Spine Surg. 2020 May 1; 33 (4): E185-E190.

    Study DesignThis was a cross-sectional cohort study.ObjectiveThe objective of this study was to identify the prevalence of sleep disturbance in patients with symptomatic lumbar spinal stenosis (LSS) and to establish the relationship between sleep disturbance and both functional disability and health-related quality of life in patients with symptomatic LSS.Summary Of Background DataDespite the possible association between LSS and poor sleep quality, there has been no study regarding the relationship between LSS and sleep disturbance.Materials And MethodsA total of 148 patients with LSS were divided into the poor sleeper and nonpoor sleeper groups according to Global Pittsburgh Sleep Quality Index (PSQI) score. Demographic data, Visual Analog Scale (VAS) score for back and leg pain, Oswestry Disability Index (ODI), and EuroQol 5-dimension questionnaire (EQ-5D) were compared between both groups. Multiple regression analysis was performed with ODI or ODI without sleep component as the dependent variable and age, sex, PSQI, VAS for back pain, VAS for leg pain as independent variables.ResultsOf the 148 patients who participated in this study, 54 (36.5%) and 94 (63.5%) patients were classified into nonpoor sleeper and poor sleeper groups. Although there were no differences in demographic data or VAS for back or leg pain between the nonpoor sleeper and poor sleeper groups, poor sleepers demonstrated significantly higher ODI scores, and lower EQ-5D than nonpoor sleepers (P=0.003 and 0.004, respectively). There were significant correlations between the global PSQI score and both the ODI score and EQ-5D. Although the surgical treatment group showed significantly higher VAS for back pain, VAS for leg pain, ODI scores, and lower EQ-5D than the conservative treatment group, the ratio of poor to nonpoor sleepers was not different between both groups (P=0.733). In the surgical treatment group, the percent of poor sleeper decreased from 65.1% to 47.6% 6 months after surgery (P<0.001).ConclusionsThe present study demonstrated that 'poor sleep quality' is a prevalent condition (63.5%) in patients with symptomatic LSS. Poor sleep quality has an adverse effect on functional disability and health-related quality of life in symptomatic LSS patients.

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