Various types of sleep disturbance due to different sorts of low back pain: A literature review – 1. Types of sleep disturbance

Abstract Aim This is part of a literature review series and a data analysis study, which seek to find out whether different types of sleep disturbance can be caused by different sorts of back pain. Here, in Part 1, we examine the systems described as an insomnia or sleep disturbance questionnaire, diary, index, item, or scale. Those used in back pain studies were of particular interest. Methods A search of Medline, Embase, Psycinfo, and the OVID journals databases was made using the keywords ‘low back pain’ and ‘sleep’. Results Forty-four sleep enquiry systems were traced. Their similarities and differences were displayed in tables. Discussion Creating the main display table helped us to sort out the considerable variation in questionnaire content. It was important to distinguish the elements of impairment, disability, and handicap and further consequences. It also helped us to rigidly define the 24-hour time sequence. First, there were the evening difficulties getting off to sleep. Then, nighttime awakenings and other disturbances were listed along with total night scores. Then, the morning waking process and conditions were distinguished. Lastly, the daytime fallout was noted. Further clarity was sought for the wording of questions by recognizing the many synonyms for tiredness and somnolence, which seemed to imply there were far more sleep items than really exist. It was noted that the results of using these subjective opinions obtained from patients often varied considerably with the objective measures recorded using actigraphy and polysomnography. Little is known as to why there is such divergence.