Patients with neck pain are less likely to improve if they experience poor sleep quality: a prospective study in routine practice.

Sleep is an integral part of a healthy, normal routine and poor sleep should not be overlooked as having an impact on rehabilitation. The objective of this study was to see whether sleep quality (SQ) at baseline is associated with improvement in pain and disability at 3 months. 422 sub-acute and chronic neck pain sufferers were recruited by 32 healthcare institutions. Neck pain, referred pain, disability, catastrophizing, depression, and SQ were assessed through validated questionnaires, upon recruitment and 3 months later. Correlations between baseline scores were calculated through the Spearman coefficient. Improvements in NP, disability, and SQ were defined as a reduction of ≥30% of baseline score. Six estimative logistic regression models were developed to assess the statistical changes in outcome measures. Regression models showed that better sleep quality at baseline was associated with improvement of neck pain (odds ratio=0.91 [95% confidence interval, 0.83-0.99]), but not disability (1.04 [0.95-1.13]); the improvement of sleep quality was associated with more severe neck pain at baseline (1.26 [1.07-1.49)], but not with baseline disability (0.99 [0.97-1.02]); and that improvement in sleep quality was associated with improvements in neck pain (3.48 [1.68-7.20]), and disability (5.02 [2.39-10.11]).

In conclusion neck pain is less likely to improve in patients with poorer sleep quality, irrespective of age, sex, catastrophizing, depression, or treatments prescribed for neck pain. Future studies should confirm these results with more severely impaired patients.