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  • The Painful Relationship Shared by Spinal Injury and Sleep Disorders

    Final Number:

    Pennie Susan Seibert PhD; Christian G. Zimmerman MD, FACS, MBA; Jennifer Valerio; Yustina Rafla; Fred Grimsley

    Study Design:
    Laboratory Investigation

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: People who sustain spinal injury (SI) also routinely complain about sleep disturbances. This coexistence negatively impacts general health, well-being, and recovery. Investigations of this complex relationship have been constrained by difficulty in acquiring valid data from people whose sleep disorder (SD) diagnoses are based on complete nocturnal polysomnography (NP) and multiple sleep latency tests (MSLT) rather than simple self-report data.

    Methods: We constructed an 111-item questionnaire to use in conjunction with NP, MSLT, the Epworth Sleepiness Scale (ESS), and medical chart reviews of people referred for evaluation of SDs.

    Results: We analyzed data from 721people who were diagnosed with SD (319 females, 402 males) with a mean age of 49.26. Of these, 43% reported chronic pain (CP) associated with back pain. Spinal injury was reported by 58 participants (24 male; 34 female; mean age of 50.09). Analyses of the SI versus no SI groups revealed numerous significant differences. For example, comparisons of the groups during NPS revealed those with SI had significantly greater prevalence of diagnoses of poor sleep efficiency, periodic limb movement, hypersomnolence , primary snoring, and nocturnal hypoxemia, and spent less time in stage N3. People with SI were more likely to have asthma, nasal/sinus problems, severe heartburn/acid reflux, headaches, difficulty concentrating, memory problems, allergies, ADHD, chronic lung disease, chronic pain, and stroke. They also were more likely to talk in their sleep, have bizarre dreams, wet the bed, report accidents due to sleepiness, and complain of sleepiness interfering with their work and social lives. Analyses of the CP versus no CP groups also revealed numerous significant differences.

    Conclusions: Understanding the relationship shared by SI and SD can facilitate best treatment practices for spinal injury as well as assist in comprehending the complex concomitance of pain and sleep disorders.

    Patient Care: Help identify the relationship shared by spinal injury and sleep disorders.

    Learning Objectives: 1. Provide an overview of the relationship shared by pain and sleep disorders. 2. Advance knowledge specific to the relationship shared by spinal injury and sleep disorders. 3. Facilitate best treatment modalities when considering spinal injury.


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