Prevalence of Insomnia in Patients with Chronic Low Back Pain; A Cross-sectional Study
DOI:
https://doi.org/10.55735/hjprs.v5i2.349Keywords:
Chronic low back pain, Insomnia, Oswestry disability indexAbstract
Background: A common musculoskeletal ailment that has a substantial influence on both physical and mental health is chronic low back pain. This pain is frequently linked to insomnia, which exacerbates emotional distress and pain intensity. Reduced quality of life, functional limitations, and worsening pain perception have all been connected to sleep disturbances. Finding out how common insomnia is in patients with chronic low back pain and examining the connection between the severity of insomnia and pain intensity are the objectives of this study. Objective: To determine the prevalence of insomnia in patients with chronic low back pain. Methodology: A cross-sectional study involving 65 participants who had CLBP for six months was carried out. The Oswestry Disability Index and the Numeric Rating Scale were used to measure functional disability and pain intensity, respectively, while the Insomnia Severity Index was used to measure the severity of insomnia. About 65 patients who had had chronic low back pain for longer than six months were included in the study. A confirmed diagnosis of chronic low back pain lacking radicular symptoms, being older than 18, and being able to comprehend and finish the questionnaire were requirements for inclusion. Acute low back pain, recent spinal surgery, and primary sleep disorders apart from insomnia were among the exclusion criteria. The prevalence was ascertained using descriptive statistics, and the associations between insomnia and pain parameters were evaluated using correlation analysis. Results: Among 65 participants, moderate clinical insomnia was present in 21.5%, severe clinical insomnia in 63.1%, sub-threshold insomnia in 9.2%, and no insomnia in 6.2% of cases. Higher insomnia scores were found to be significantly correlated with more severe pain, indicating that sleep disturbances may be a contributing factor to increased pain perception and disability. Conclusion: Almost 63.1% of people with CLBP suffer from severe clinical insomnia, indicating a high prevalence of insomnia in this population. The results show that sleep disturbances and pain intensity are strongly correlated, highlighting the necessity of integrated pain management strategies that take into account both physical and sleep-related factors.
References
Xu S, Chen J, Wang C, Lin Y, Huang W, Zhou H, et al. Global, regional, and national burden of low back pain for adults aged 55 and older 1990–2021: an analysis for the global burden of disease study 2021. BMC Musculoskeletal Disorders. 2025;26(1):81.
Kaye AD, Archer JR, Shah S, Johnson CD, Herron LR, Brouillette AE, et al. Spinal Cord Stimulation for Low Back Pain: A Systematic Review. Current Pain and Headache Reports. 2025;29(1):2.
Nicol V, Verdaguer C, Daste C, Bisseriex H, Lapeyre É, Lefèvre-Colau M-M, et al. Chronic low back pain: a narrative review of recent international guidelines for diagnosis and conservative treatment. Journal of Clinical Medicine. 2023;12(4):1685.
Wong CK, Mak RY, Kwok TS, Tsang JS, Leung MY, Funabashi M, et al. Prevalence, incidence, and factors associated with non-specific chronic low back pain in community-dwelling older adults aged 60 years and older: a systematic review and meta-analysis. The Journal of Pain. 2022;23(4):509-34.
Roach M, Juday T, Tuly R, Chou JW, Jena AB, Doghramji PP. Challenges and opportunities in insomnia disorder. International Journal of Neuroscience. 2021;131(11):1058-65.
Bollu PC, Kaur H. Sleep medicine: insomnia and sleep. Missouri medicine. 2019;116(1):68.
Van Looveren E, Bilterys T, Munneke W, Cagnie B, Ickmans K, Mairesse O, et al. The association between sleep and chronic spinal pain: a systematic review from the last decade. Journal of Clinical Medicine. 2021;10(17):3836.
Andersen ML, Araujo P, Frange C, Tufik S. Sleep disturbance and pain: a tale of two common problems. Chest. 2018;154(5):1249-59.
Bilterys T, Siffain C, De Maeyer I, Van Looveren E, Mairesse O, Nijs J, et al. Associates of insomnia in people with chronic spinal pain: a systematic review and meta-analysis. Journal of Clinical Medicine. 2021;10(14):3175.
Skarpsno ES, Mork PJ, Marcuzzi A, Nilsen TIL, Meisingset I. Subtypes of insomnia and the risk of chronic spinal pain: the HUNT study. Sleep Medicine. 2021;85:15-20.
Luo G, Yao Y, Tao J, Wang T, Yan M. Causal association of sleep disturbances and low back pain: a bidirectional two-sample Mendelian randomization study. Frontiers in Neuroscience. 2022;16:1074605.
Li MT, Robinson CL, Ruan QZ, Surapaneni S, Southerland W. The influence of sleep disturbance on chronic pain. Current Pain and Headache Reports. 2022;26(10):795-804.
Husak AJ, Bair MJ. Chronic pain and sleep disturbances: a pragmatic review of their relationships, comorbidities, and treatments. Pain Medicine. 2020;21(6):1142-52.
Amundsen PA, Evans DW, Rajendran D, Bright P, Bjørkli T, Eldridge S, et al. Inclusion and exclusion criteria used in non-specific low back pain trials: a review of randomised controlled trials published between 2006 and 2012. BMC Musculoskeletal Disorders. 2018;19:1-13.
Manzar MD, Jahrami HA, Bahammam AS. Structural validity of the Insomnia Severity Index: A systematic review and meta-analysis. Sleep Medicine Reviews. 2021;60:101531.
Goudman L, Pilitsis J, Billet B, De Vos R, Hanssens K, Billot M, et al. The level of agreement between the numerical rating scale and visual analogue scale for assessing pain intensity in adults with chronic pain. Anaesthesia. 2024;79(2):128-38.
Koivunen K, Widbom-Kolhanen S, Pernaa K, Arokoski J, Saltychev M. Reliability and validity of Oswestry Disability Index among patients undergoing lumbar spinal surgery. BMC Surgery. 2024;24(1):13.
Rodríguez MMD, Corralejo SM, Vouvalis N, Mirly AK. Institutional review board: Ally not adversary. PSI CHI, The International Honor Society in Psychology. 2017;22(2):76-84.
Pandis N. The chi-square test. American Journal of Orthodontics and Dentofacial Orthopedics. 2016;150(5):898-9.
Mathias J, Cant M, Burke A. Sleep disturbances and sleep disorders in adults living with chronic pain: a meta-analysis. Sleep Medicine. 2018;52:198-210.
Ho KK, Skarpsno ES, Nilsen KB, Ferreira PH, Pinheiro MB, Hopstock LA, et al. A bidirectional study of the association between insomnia, high-sensitivity C-reactive protein, and comorbid low back pain and lower limb pain. Scandinavian Journal of Pain. 2023;23(1):110-25.
Cheatle MD, Foster S, Pinkett A, Lesneski M, Qu D, Dhingra L. Assessing and managing sleep disturbance in patients with chronic pain. Anesthesiology clinics. 2016;34(2):379-93.
Tagliaferri SD, Miller CT, Owen PJ, Mitchell UH, Brisby H, Fitzgibbon B, et al. Domains of chronic low back pain and assessing treatment effectiveness: a clinical perspective. Pain Practice. 2020;20(2):211-25.
Armfield N, Elphinston R, Liimatainen J, Requena SS, Eather C-E, Edirippulige S, et al. Development and Use of Mobile Messaging for Individuals With Musculoskeletal Pain Conditions: Scoping Review. JMIR mHealth and uHealth. 2024;12(1):e55625.
Burbridge C, Randall JA, Abraham L, Bush EN. Measuring the impact of chronic low back pain on everyday functioning: content validity of the Roland Morris disability questionnaire. Journal of Patient-Reported Outcomes. 2020;4:1-15.
Gopali BL. Impact of chronic low back pain on activities of daily living among patients with low back pain attended at the musculoskeletal department, CRP, Savar, Dhaka, Bangladesh: Bangladesh Health Professions Institute, Faculty of Medicine, the University; 2019.
Malfliet A, De Baets L, Bilterys T, Van Looveren E, Mairesse O, Cagnie B, et al. Cognitive Behavioral Therapy for Insomnia in Pain Management for Nonspecific Chronic Spinal Pain: A Randomized Clinical Trial. JAMA Network Open. 2024;7(8):e2425856-e.
Karaman S, Karaman T, Dogru S, Onder Y, Citil R, Bulut Y, et al. Prevalence of sleep disturbance in chronic pain. Eur Rev Med Pharmacol Sci. 2014;18(17):2475-81.
Downloads
Published
License
Copyright (c) 2025 The Healer Journal of Physiotherapy and Rehabilitation Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
