Sleep, Pain and Function in People With Chronic Spinal Pain and Comorbid Insomnia

Inclusion criteria

cases:

• nonspecific spinal pain (≥3 days per week and ≥3 months of chronic low back pain, failed back surgery syndrome > 3 years prior, chronic whiplash, or chronic non traumatic neck pain)
• aged between 18 and 65 years
• seeking care because of neck pain or low back pain
• native dutch speaker
• having insomnia: in the absence of other intrinsic sleep disorders and shift work, insomnia is defined as > 30 minutes of sleep latency and/or minutes awake after sleep onset for > 3 days / week for > 6 months
• living or working within a radius of 50 km around the test location
• not starting new treatments or medication and continuing their usual care 6 weeks prior to and during study participation (to obtain steady state)
• referring from analgesics, caffeine, alcohol or nicotine in the previous 48 h of the assessments
• nonspecific failed back surgery > 3 years are permitted
• not undertaking exercise (>3 metabolic equivalents) 3 days before the experiment

Exclusion criteria

cases:

• severe underlying sleep pathology (identified through baseline data of polysomnography)
• neuropathic pain
• chronic widespread pain
• being pregnant or pregnancy (including giving birth) in the preceding year
• history of specific spinal surgery
• thoracic pain in absence of neck or low back pain
• shift workers
• present clinical depression
• BMI ≥ 30

Inclusion criteria

controls:

• native dutch speaking
• 18 to 65 years of age
• having chronic nonspecific chronic spinal pain (≥3 days per week and ≥3 months of chronic low back pain, failed back surgery syndrome > 3 years prior, chronic whiplash, or chronic non traumatic neck pain)
• referring from analgesics, caffeine, alcohol or nicotine in the previous 48 h of the assessments
• not undertaking exercise (>3 metabolic equivalents) 3 days before the experiment
• No new medication 6 weeks prior to the assessment
• currently not undergoing any treatment (excl. medication) for chronic spinal pain

Exclusion criteria

controls:

• specific medical conditions (neuropathic pain, specific neck of back surgery, osteoporotic vertebral fractures, or rheumatologic diseases)
• chronic widespread pain syndromes (fibromyalgia or chronic fatigue syndrome)
• having insomnia (in the absence of other intrinsic sleep disorders and shift work, insomnia is defined as > 30 minutes of sleep latency and/or minutes awake after sleep onset for > 3 days / week for > 6 months)
• severe underlying sleep pathology
• being pregnant or pregnancy in the preceding year
• thoracic pain in the absence of neck or low back pain
• diagnosed depression
• BMI over 30