Quality of sleep in individuals with spinal cord injury: A comparison between patients with and without pain

Abstract

Study design: A cross-sectional descriptive study of self-reported quality of sleep in individuals with a spinal cord injury (SCI). Objectives: To assess and describe subjective quality of sleep in patients with SCI, with and without pain. Setting: Spinalis SCI unit, Stockholm, Sweden. Methods: A total of 230 patients with an SCI were mailed a questionnaire containing queries about pain intensities, pain unpleasantness, mood, and sleep quality (Basic Nordic Sleep Questionnaire) to assess quality of sleep in patients with SCI with and without pain. Results: Of the 192 questionnaires that were returned (response rate 83.4%), 191 were analysed. Patients were divided into three groups: (1) those who reported no pain (n = 50), (2) those who reported intermittent pain (n = 42), and (3) those who suffered from continuous pain (n = 99). Patients suffering from continuous pain rated pain intensity and unpleasantness significantly higher than those who only suffered from intermittent pain. The group with continuous pain also reported the poorest quality of sleep and the highest ratings of anxiety and depression of the three groups. Anxiety, together with pain intensity and depression, were the main predictors for poor sleep quality. Conclusions: Poor subjective sleep quality was associated with higher ratings of pain intensity, anxiety, and depression. It is possible that melatonin serves as a modulator of these different aspects. © 2005 International Spinal Cord Society All rights reserved.