| Background:Both long and short periods of sleep have been associated with negative health outcomes,particularly in middle-aged and older adults.Although sleep quality is essential for a good quality of life,sleep quality is not properly measured and treated in patients with lumbar disc herniation.Lumbar disc herniation(LDH)is one of the most common cause of lumbocrural pain,and possesses the characteristics of high incidence and high morbidity.Pain caused by herniated nucleus pulposus tissue oppressed nerve root has great impact on the patient's quality of life.E specially the presence of nocturnal pain lead to poor sleep quality and short sleep duration within the LDH patients,eventually cause changes in the system of the body because of sleep disorder.Studies that investigate the prevalence of sleep disturbances and identify high-risk patients are essential to help understand mechanisms of sleep disturbance in patients with LDH,develop multimodal treatment strategies,and eventually improve the clinical outcome for LDH.Objective:The purpose of this study was to investigate the incidence and status of sleep disorders in patients with lumbar disc herniation by collecting sleep-related data from patients with lumbar disc herniation admitted to Qilu Hospital of Shandong University,and to understand the mechanism by identifying risk factors.Methods:This cross-sectional study included 108 patients admitted to Qilu Hospital of Shandong University from September 2019 to March 2020,with an average age of 46.6 years.The diagnosis of lumbar disc herniation is based on the symptoms such as lumbar and lower limb radiation pain or numbness,weakness of lower limb,defecation and urination dysfunction,Lasegue sign and other signs,as well as MRI,CT and other imaging manifestations.Sleep quality was quantified by the Pittsburgh sleep quality index(PSQI),and the enrolled patients were divided into two groups:Patients with sleep disturbance(total PSQI score?6)and Patients without sleep disturbance(total PSQI score?5).Data on age,height,weight,drinking,coffee,night pain,chronic lower limb joint pain,and chronic upper limb joint pain were collected through questionnaires.IMPAX imaging system of Qilu Hospital of Shandong University was used to collect the imaging data of lumbar range of motion,lumbar lordosis,pelvic tilt,sacral slope and pelvic incidence.Multivariate logistic regression analysis was conducted to identify significant risk factors related to sleep disturbance.Results:A total of 108 patients were included in this study,including 65(60.2%)female patients and 43(39.8%)male patients,with an average age of 46.6 years.64(59.3%)patients were defined as having sleep disturbance and 44(40.7%)patients were defined as not having sleep disorder.The total score of PSQI and the scores of 6 PSQI subaggregate,including sleep quality,sleep latency,sleep duration,and sleep disturbance,habitual sleep efficiency and daytime dysfunction,all showed significant differences between the two groups,while the scores of the use of sleep medications subaggregate showed no statistically significant differences between the two groups.By multivariate logistic regression analysis,sleep disturbance was consistently associated with the older patients(OR?1.349,P=0.015),the female sex(OR?2.099,P=0.047),sedentary patients(OR?0.012,P?0.004),high VAS score(OR?5.845,P=0.001),the presence of chronic upper limb pain(OR=0.015,P?0.016),and decreased lumbar lordosis(OR?0.727,P=0.002),respectively,after adjusting for age,sex,occupation,BMI,alcohol,coffee,tea,VAS score,presence of nocturnal pain,chronic lower limb joint pain,chronic upper limb joint pain,lumbar range of motion,lumbar lordosis,sacral slope and pelvic incidence.Conclusions:This study identified potential high-risk groups for sleep disturbance among patients with LDH.Proper caution and evaluation for these patients,along with further studies about their treatment outcomes,are required. |
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