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Sleep disturbances and back pain

Systematic review and meta-analysis

Schlafstörungen und Rückenschmerzen

Systematischer Review und Metaanalyse

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Summary

Background

In today’s society, sleep disturbances and back pain are both common problems which threaten health. Although some studies have focused on the effects of sleep disturbances on back pain, no meta-analysis has been done. The purpose of this study is to systematically review and perform a meta-analysis on the effects of sleep disturbances on back pain.

Methods

A literature search in PubMed, Scopus and EMBASE with keywords until June 2019 was performed. The eligible articles were evaluated qualitatively and the results were pooled using random effects. The publication bias and the degree of heterogeneity were examined.

Results

In all, 21 studies were included in the meta-analysis. Sleep disturbances were associated with back pain (odds ratio 1.52; confidence interval [CI] 1.37–1.68; P < 0.001). In men, the odds ratio was 1.49 (CI 1.34–1.65; P < 0.001). In women, the odds ratio was 1.56 (CI 1.33–1.81; P < 0.001). Begg’s test (P = 0.856) and Egger test (P = 0.188) did not show any publication bias. A funnel plot and trim-and-fill method showed publication bias, and heterogeneity was also high.

Conclusions

Sleep disturbance is associated with risk of back pain. Improving sleep can be a deterrent against back pain. Therefore, interventions to reduce sleep disturbances can help to improve health. On the other hand, the relationship between sleep disturbances and back pain can be two-sided, and back pain can also lead to sleep disturbances. Not only in view of the lifetime prevalence and the multifactorial impairments of those affected, but also in consideration of social and economic burdens, this issue will remain of considerable importance.

Zusammenfassung

Hintergrund

In der heutigen Gesellschaft sind sowohl Schlafstörungen als auch Rückenschmerzen häufige gesundheitsgefährdende Probleme. Zwar haben einige Studien auf die Auswirkungen von Schlafstörungen auf Rückenschmerzen fokussiert, doch bislang gibt noch keine Metaanalyse zu dieser Thematik. Ziel der vorliegenden Studie ist es, die Auswirkungen von Schlafstörungen auf Rückenschmerzen systematisch zu überprüfen und eine Metaanalyse durchzuführen.

Methodik

In PubMed, Scopus und EMBASE wurde mit Stichworten bis Juni 2019 nach Literatur gesucht. Die infrage kommenden Artikel wurden qualitativ bewertet und die Ergebnisse unter Verwendung von Zufallseffekten gepoolt. Untersucht wurden ein möglicher Publikationsbias und der Grad der Heterogenität.

Ergebnisse

Insgesamt wurden 21 Studien in die Metaanalyse einbezogen. Schlafstörungen waren mit Rückenschmerzen assoziiert (Odds Ratio [OR] 1,52; Konfidenzintervall [KI] 1,37‑1,68; p < 0,001). Bei den Männern betrug die OR 1,49 (KI 1,34‑1,65; p < 0,001). Bei Frauen betrug die OR 1,56 (KI 1,33‑1,81; p < 0,001). Der Begg-Test (p = 0,856) und der Egger-Test (p = 0,188) zeigten keinen Publikationsbias, wohl dagegen ein Funnel-Plot und die „trim-and-fill method“. Die Heterogenität war ebenfalls hoch.

Schlussfolgerungen

Schlafstörungen sind mit dem Risiko von Rückenschmerzen verbunden. Verbesserter Schlaf kann Rückenschmerzen abhalten. Daher können Interventionen zur Verringerung von Schlafstörungen einen Beitrag zur Verbesserung der Gesundheit leisten. Andererseits kann der Zusammenhang zwischen Schlafstörungen und Rückenschmerzen umgekehrt sein sein: Rückenschmerzen können auch zu Schlafstörungen führen. Nicht nur angesichts der Lebenszeitprävalenz und der multifaktoriellen Beeinträchtigungen der Betroffenen, sondern auch im Hinblick auf die sozialen und ökonomischen Belastungen wird diese Thematik von erheblicher Bedeutung bleiben.

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  1. Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Sohrab Amiri

  2. Kharazmi University, Tehran, Iran

    Sepideh Behnezhad

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Studies included in the meta-analysis

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Amiri, S., Behnezhad, S. Sleep disturbances and back pain. Neuropsychiatr 34, 74–84 (2020). https://doi.org/10.1007/s40211-020-00339-9

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