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Prevalence of sleep disturbance in patients with cervical radiculopathy and an analysis of risk factors: a cross-sectional study

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Abstract

Objective

Previous research has shown that many patients with musculoskeletal diseases suffer from sleep disturbances. However, the sleep quality of patients with cervical radiculopathy (CR) has yet to be fully investigated. This study aims to investigate the prevalence and status of sleep disturbances in patients with CR and identify the mechanisms and risk factors associated with this condition.

Methods

We conducted a cross-sectional study of patients diagnosed with CR. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used to evaluate the sleep quality of patients and determine whether patients experience sleep disturbances. In addition, we analyzed the clinical and radiological risk factors of sleep disturbance and determined the key risk factors related to sleep disturbance by multivariable analysis.

Results

According to specific inclusion and exclusion criteria, 186 patients with CR were finally included, with a mean age of 59.1 ± 14.3 years, of which 113 (60.8%) were female. Sleep disturbance was defined as a PSQI score ≥ 6 and was identified in 56.5% of patients (105/186). By performing multivariate analysis, we determined that sleep disturbance was closely related to the female gender, a higher Beck Depression Inventory (BDI) score, a reduction in cervical mobility, an increase in C2-C7 sagittal vertical axis (C2-C7 SVA), and severe asymmetry of the paravertebral muscle at C5 and C6 levels.

Conclusion

In this study, we identified the high prevalence and potential high-risk factors of sleep disturbance in patients with CR. Clinicians should closely evaluate and monitor such patients and consider appropriate treatment strategies.

Level of evidence

IV.

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Abbreviations

CR:

Cervical radiculopathy

PSQI:

Pittsburgh sleep quality index

NDI:

Neck disability index

VAS:

Visual analog scale

BDI-II:

Beck depression inventory

CSA:

Total cross-sectional area

OCI:

The occipital-cervical angle

C2-C7 SVA:

C2-C7 Sagittal vertical axis

SCA:

Spino cranial angle

References

  1. Luyster FS, Strollo PJ, Zee PC, Walsh JK (2012) Sleep: a health imperative. Sleep 35:727–734. https://doi.org/10.5665/sleep.1846

    Article  PubMed  PubMed Central  Google Scholar 

  2. Smolensky MH, Di Milia L, Ohayon MM, Philip P (2011) Sleep disorders, medical conditions, and road accident risk. Accid Anal Prev 43:533–548. https://doi.org/10.1016/j.aap.2009.12.004

    Article  PubMed  Google Scholar 

  3. Irwin MR (2015) Why sleep is important for health: a psychoneuroimmunology perspective. Annu Rev Psychol 66:143–172. https://doi.org/10.1146/annurev-psych-010213-115205

    Article  PubMed  Google Scholar 

  4. Riemann D, Baglioni C, Bassetti C et al (2017) European guideline for the diagnosis and treatment of insomnia. J Sleep Res 26:675–700. https://doi.org/10.1111/jsr.12594

    Article  PubMed  Google Scholar 

  5. van de Straat V, Bracke P (2015) How well does Europe sleep? a cross-national study of sleep problems in European older adults. Int J Public Health 60:643–650. https://doi.org/10.1007/s00038-015-0682-y

    Article  PubMed  Google Scholar 

  6. Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6:97–111. https://doi.org/10.1053/smrv.2002.0186

    Article  PubMed  Google Scholar 

  7. Bohnen NI, Hu MTM (2019) Sleep disturbance as potential risk and progression factor for Parkinson’s disease. J Parkinsons Dis 9:603–614. https://doi.org/10.3233/JPD-191627

    Article  PubMed  PubMed Central  Google Scholar 

  8. Peter-Derex L, Yammine P, Bastuji H, Croisile B (2015) Sleep and Alzheimer’s disease. Sleep Med Rev 19:29–38. https://doi.org/10.1016/j.smrv.2014.03.007

    Article  PubMed  Google Scholar 

  9. Barshikar S, Bell KR (2017) Sleep disturbance after TBI. Curr Neurol Neurosci Rep 17:87. https://doi.org/10.1007/s11910-017-0792-4

    Article  PubMed  Google Scholar 

  10. Cappuccio FP, Cooper D, D’Elia L et al (2011) Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J 32:1484–1492. https://doi.org/10.1093/eurheartj/ehr007

    Article  PubMed  Google Scholar 

  11. Mogavero MP, DelRosso LM, Fanfulla F et al (2021) Sleep disorders and cancer: state of the art and future perspectives. Sleep Med Rev 56:101409. https://doi.org/10.1016/j.smrv.2020.101409

    Article  PubMed  Google Scholar 

  12. Kim J, Kim G, Kim SW et al (2021) Changes in sleep disturbance in patients with cervical myelopathy: comparison between surgical treatment and conservative treatment. Spine J 21:586–597. https://doi.org/10.1016/j.spinee.2021.01.007

    Article  PubMed  Google Scholar 

  13. Kelly GA, Blake C, Power CK et al (2011) The association between chronic low back pain and sleep: a systematic review. Clin J Pain 27:169–181. https://doi.org/10.1097/AJP.0b013e3181f3bdd5

    Article  PubMed  Google Scholar 

  14. Tang NKY, Wright KJ, Salkovskis PM (2007) Prevalence and correlates of clinical insomnia co-occurring with chronic back pain. J Sleep Res 16:85–95. https://doi.org/10.1111/j.1365-2869.2007.00571.x

    Article  PubMed  Google Scholar 

  15. Haack M, Simpson N, Sethna N et al (2020) Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology 45:205–216. https://doi.org/10.1038/s41386-019-0439-z

    Article  PubMed  Google Scholar 

  16. Li MT, Robinson CL, Ruan QZ et al (2022) The influence of sleep disturbance on chronic pain. Curr Pain Headache Rep 26:795–804. https://doi.org/10.1007/s11916-022-01074-2

    Article  CAS  PubMed  Google Scholar 

  17. Smith MT, Edwards RR, McCann UD, Haythornthwaite JA (2007) The effects of sleep deprivation on pain inhibition and spontaneous pain in women. Sleep 30(4):494–505

    Article  PubMed  Google Scholar 

  18. Parmelee PA, Tighe CA, Dautovich ND (2015) Sleep disturbance in osteoarthritis : linkages with pain. Disabil Depress Symp 67:358–365. https://doi.org/10.1002/acr.22459

    Article  Google Scholar 

  19. Smith MT, Haythornthwaite JA (2004) How do sleep disturbance and chronic pain inter-relate? insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev 8:119–132. https://doi.org/10.1016/S1087-0792(03)00044-3

    Article  PubMed  Google Scholar 

  20. Choy EHS (2015) The role of sleep in pain and fibromyalgia. Nat Rev Rheumatol 11:513–520. https://doi.org/10.1038/nrrheum.2015.56

    Article  PubMed  Google Scholar 

  21. Alsaadi SM, McAuley JH, Hush JM, Maher CG (2011) Prevalence of sleep disturbance in patients with low back pain. Eur Spine J 20:737–743. https://doi.org/10.1007/s00586-010-1661-x

    Article  PubMed  Google Scholar 

  22. Kim J, Oh JK, Kim SW et al (2021) Risk factors for sleep disturbance in patients with cervical myelopathy and its clinical significance: a cross-sectional study. Spine J 21:96–104. https://doi.org/10.1016/j.spinee.2020.09.002

    Article  PubMed  Google Scholar 

  23. Polston DW (2007) Cervical radiculopathy. Neurol Clin 25:373–385. https://doi.org/10.1016/j.ncl.2007.01.012

    Article  PubMed  Google Scholar 

  24. Abbed KM, Coumans JVCE (2007) Cervical radiculopathy: pathophysiology, presentation, and clinical evaluation. Neurosurgery 60:28–34. https://doi.org/10.1227/01.NEU.0000249223.51871.C2

    Article  Google Scholar 

  25. Beck AT, Ward CH, Mendelson M, et al (1960) An inventory for measuring depression The difficulties inherent in obtaining. pp 561–571

  26. Buysse DJ, Reynolds CF, Monk TH, et al (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res

  27. Mollayeva T, Thurairajah P, Burton K et al (2016) The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: a systematic review and meta-analysis. Sleep Med Rev 25:52–73. https://doi.org/10.1016/j.smrv.2015.01.009

    Article  PubMed  Google Scholar 

  28. Buysse DJ, Reynolds CF, Monk TH et al (1991) Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh sleep quality index (PSQI). Sleep 14:331–338. https://doi.org/10.1093/sleep/14.4.331

    Article  CAS  PubMed  Google Scholar 

  29. Bastien CH, Vallières A, Morin CM (2001) Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med 2:297–307. https://doi.org/10.1016/S1389-9457(00)00065-4

    Article  PubMed  Google Scholar 

  30. Van Looveren E, Bilterys T, Munneke W, Cagnie B, Ickmans K, Mairesse O, Meeus M (2021) The association between sleep and chronic spinal pain: a systematic review from the last decade. J Clin Med 10(17):3836

    Article  PubMed  PubMed Central  Google Scholar 

  31. Cheatle MD, Foster S, Pinkett A et al (2016) Assessing and managing sleep disturbance in patients with chronic pain. Sleep Med Clin 11:531–541. https://doi.org/10.1016/j.jsmc.2016.08.004

    Article  PubMed  Google Scholar 

  32. Novak M, Shapiro CM (1997) Drug-induced sleep disturbances. Focus Nonpsychotr Medicat Drug Saf 16:133–149. https://doi.org/10.2165/00002018-199716020-00005

    Article  CAS  Google Scholar 

  33. Van GA (2018) Drug-induced insomnia and excessive sleepiness. Sleep Med Clin. https://doi.org/10.1016/j.jsmc.2018.02.001

    Article  Google Scholar 

  34. Roth T, Arnold LM, Garcia-Borreguero D et al (2014) A review of the effects of pregabalin on sleep disturbance across multiple clinical conditions. Sleep Med Rev 18:261–271. https://doi.org/10.1016/j.smrv.2013.07.005

    Article  PubMed  Google Scholar 

  35. Smagula SF, Stone KL, Fabio A, Cauley JA (2016) Risk factors for sleep disturbances in older adults: evidence from prospective studies. Sleep Med Rev 25:21–30. https://doi.org/10.1016/j.smrv.2015.01.003

    Article  PubMed  Google Scholar 

  36. Fang H, Tu S, Sheng J, Shao A (2019) Depression in sleep disturbance: a review on a bidirectional relationship, mechanisms, and treatment. J Cell Mol Med 23:2324–2332. https://doi.org/10.1111/jcmm.14170

    Article  PubMed  PubMed Central  Google Scholar 

  37. Alvin MD, Miller JA, Lubelski DD et al (2016) The impact of preoperative depression and health state on quality-of-life outcomes after anterior cervical diskectomy and fusion. Glob Spine J 6:306–313. https://doi.org/10.1055/s-0035-1562932

    Article  Google Scholar 

  38. Vernon H, Mior S (1991) The neck disability index: a study of reliability and validity. J Manipulative Physiol Ther 14:409–415

    CAS  PubMed  Google Scholar 

  39. Li Y, Zhang S, Zhu J et al (2012) Sleep disturbances are associated with increased pain, disease activity, depression, and anxiety in ankylosing spondylitis: a case-control study. Arthritis Res Ther 14:R215. https://doi.org/10.1186/ar4054

    Article  PubMed  PubMed Central  Google Scholar 

  40. Mulligan EP, Brunette M, Shirley Z, Khazzam M (2015) Sleep quality and nocturnal pain in patients with shoulder disorders. J shoulder Elb Surg 24:1452–1457. https://doi.org/10.1016/j.jse.2015.02.013

    Article  Google Scholar 

  41. MacDowall A, Skeppholm M, Robinson Y, Olerud C (2018) Validation of the visual analog scale in the cervical spine. J Neurosurg Spine 28:227–235. https://doi.org/10.3171/2017.5.SPINE1732

    Article  PubMed  Google Scholar 

  42. Patwardhan AG, Khayatzadeh S, Havey RM et al (2018) Cervical sagittal balance: a biomechanical perspective can help clinical practice. Eur spine J 27:25–38. https://doi.org/10.1007/s00586-017-5367-1

    Article  PubMed  Google Scholar 

  43. Scheer JK, Tang JA, Smith JS et al (2013) Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine 19:141–159. https://doi.org/10.3171/2013.4.SPINE12838

    Article  PubMed  Google Scholar 

  44. Iyer S, Nemani VM, Nguyen J et al (2016) Impact of cervical sagittal alignment parameters on neck disability. Spine 41:371–377. https://doi.org/10.1097/BRS.0000000000001221

    Article  PubMed  Google Scholar 

  45. Falla D, Farina D (2007) Neural and muscular factors associated with motor impairment in neck pain. Curr Rheumatol Rep 9:497–502. https://doi.org/10.1007/s11926-007-0080-4

    Article  PubMed  Google Scholar 

  46. Noormohammadpour P, Dehghani-Firouzabadi A, Mansournia MA et al (2017) Comparison of the cross-sectional area of longus colli muscle between patients with cervical radicular pain and healthy controls. PM R 9:120–126. https://doi.org/10.1016/j.pmrj.2016.06.020

    Article  PubMed  Google Scholar 

  47. Lin T, Wang Z, Chen G, Liu W (2021) Predictive effect of cervical spinal cord compression and corresponding segmental paravertebral muscle degeneration on the severity of symptoms in patients with cervical spondylotic myelopathy. Spine J 21:1099–1109. https://doi.org/10.1016/j.spinee.2021.03.030

    Article  PubMed  Google Scholar 

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Acknowledgements

The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No relevant financial activities outside the submitted work

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Author notes

  1. Tengbin Shi and Wenge Liu have contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou, Fuzhou, 086-350001, Fujian, People’s Republic of China

    Tengbin Shi, Zhi Chen, Zhenyu Wang & Wenge Liu

  2. School of Health, Fujian Medical University, Fuzhou, 350108, Fujian, People’s Republic of China

    Wenwen Li & Wenge Liu

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  1. Tengbin Shi
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Correspondence to Wenge Liu.

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Ethics Committee of Fujian Medical University Union Hospital approved this study. Informed consent was waived by the Committee (IEC/IRB No: 2022KY171). All data were anonymized.

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Shi, T., Chen, Z., Li, W. et al. Prevalence of sleep disturbance in patients with cervical radiculopathy and an analysis of risk factors: a cross-sectional study. Eur Spine J 32, 1624–1635 (2023). https://doi.org/10.1007/s00586-023-07655-y

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