Risk factors for sleep disturbance in patients with cervical myelopathy and its clinical significance: a cross-sectional study |
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| Authors: | Jihye Kim Jae-Keun Oh Seok Woo Kim Jae Sung Yee Tae-Hwan Kim |
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| Affiliation: | 1. Division of Infection, Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea;2. Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22, Gwanpyeong-ro, 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do 14068, Republic of Korea;1. Department of Spine Surgery, Ganga Hospital, 313, Mettupalayam Rd, Coimbatore, India;2. Ganga Research Centre, No 91, Mettupalayam Rd, Coimbatore 641030, India;3. Department of Plant Biotechnology, Tamil Nadu agricultural university, Coimbatore 641003, India;4. Aravind Medical Research Foundation, Madurai 625020, India;1. Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, Baltimore, MD 21287, USA;2. Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, Baltimore, MD 21287, USA;1. The University of Texas Dell Medical School, Ascension Texas Spine and Scoliosis, Austin, TX, USA;3. State University of New York Upstate Medical University, 750 East Adams St, Syracuse, NY 13210-2375, USA;4. Tufts Medical Center, 800 Washington St, Boston, MA 02111, USA;5. Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA;6. Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA;1. Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital of SooChow University, 708 Renmin Rd, Suzhou, Jiangsu 215007, People''s Republic of China;2. Department of Orthopedics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, People''s Republic of China;3. Department of Geriatrics, Xinghu Hospital, SuZhou industrial park, Suzhou, Jiangsu, People''s Republic of China;4. Department of Endocrinology, The First Affiliated Hospital of SooChow University, Suzhou, Jiangsu, People''s Republic of China;5. Orthopedics and Sports medicine center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215000, Jiangsu, People''s Republic of China;1. Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Canada;2. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;3. Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada |
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| Abstract: | BACKGROUND CONTEXTSleep disturbance is highly prevalent in patients with spinal cord injury and is one of the most important clinical issues affecting their quality of life. However, it has not been properly measured or treated in patients with cervical myelopathy (CM), although most typical or atypical symptoms of CM are known to be risk factors for sleep disturbance. In addition, previous studies identified that the presence of sleep disturbance is unintentionally missed under the current evaluation process for degenerative spinal disease without direct investigation using validated tools for sleep. Therefore, studies about sleep disturbances in patients with CM are essential.PURPOSEThe purpose of this study was to investigate the prevalence of sleep disturbance in patients with CM using validated tools and to understand its mechanism by identifying high-risk patients.STUDY DESIGN/SETTINGCross-sectional study.PATIENT SAMPLEConsecutive patients diagnosed with CM.OUTCOME MEASURESPittsburgh sleep quality index.METHODSThis study was performed on patients diagnosed with CM. Sleep disturbance was determined using the Pittsburgh sleep quality index. Variables associated with sleep disturbance including demographics, lifestyle, medical history, and radiologic parameters were investigated. Independent risk factors related to sleep disturbance were identified using multivariate logistic regression analysis.RESULTSA total of 203 patients with CM were included in our study. Among them, 126 patients (62.1%) were men, and the mean age was 63.0 years. Despite male predominance, sleep disturbance was identified in 71.4% of patients (145 of 203). Multivariate analysis identified a worse depression scale score, a lower modified Japanese Orthopedic Association score, chronic shoulder joint pain, smaller spinal cord area, and decreased cervical range of motion as independent risk factors for sleep disturbance.CONCLUSIONSIn patients with CM, sleep disturbance was associated with a more severe type of myelopathy. Further studies including polysomnography and measurement of melatonin will be helpful to identify the mechanisms of the sleep disturbance in patients with CM and to improve their quality of life and clinical outcomes. |
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