Chronic low back pain and sleep disorders in older adults: a cross-sectional study

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Abstract
Introduction: Sleep disorders and chronic low back pain (CLBP) are prevalent conditions in older adults and can coexist in a bidirectional relationship. The aim was to investigate the associations between the risk of obstructive sleep apnoea (OSA), excessive daytime sleepiness, sleep quality with pain intensity and functional disability, and to estimate the prevalence of sleep complaints in older adults with CLBP. Materials and methods: A cross-sectional study involving older adults with CLBP aged 60 years and above from primary care was conducted. Data collected included OSA risk (Berlin Questionnaire), excessive daytime sleepiness (Epworth Sleepiness Scale), sleep quality (Pittsburgh Sleep Quality Index), pain intensity (Numerical Pain Rating Scale), functional disability (Roland–Morris Questionnaire) and sleep complaints (Sleep Complaints Questionnaire). We performed descriptive analyses and ran six univariate and multivariable linear regression models (adjusted for potential confounders). Results: Sleep quality was associated with disability, even after adjusting for confounders (0.25 [CI 95%: 0.07–0.43]). Sleep quality was also significantly associated with pain intensity (0.28 [CI 95%: 0.09–0.47]) in univariate analysis. The risk of OSA was associated with pain intensity (0.30 [CI 95%: 0.16–0.72]) and functional disability (0.33 [CI 95%: 0.20–0.75]), but only in univariate analysis. Excessive daytime sleepiness and pain intensity were negatively associated in a multivariable analysis (−0.21 [CI 95%: −0.42, to 0.01]). A prevalence of at least one sleep complaint was found in 96% of participants. Conclusions: Poor sleep quality was associated with disability, and pain intensity appeared to worsen sleep. Routine screening and interventions for sleep problems could help reduce pain, disability and healthcare burden.

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