Int J Med Sci 2017; 14(6):536-542. doi:10.7150/ijms.18926 This issue Cite

Research Paper

Clinical insomnia and associated factors in failed back surgery syndrome: a retrospective cross-sectional study

Soon Young Yun, Do Heon Kim, Hae Yoon Do, Shin Hyung Kim

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea

Citation:
Yun SY, Kim DH, Do HY, Kim SH. Clinical insomnia and associated factors in failed back surgery syndrome: a retrospective cross-sectional study. Int J Med Sci 2017; 14(6):536-542. doi:10.7150/ijms.18926. https://www.medsci.org/v14p0536.htm
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Abstract

Background Insomnia frequently occurs to patients with persistent back pain. By worsening pain, mood, and physical functioning, insomnia could lead to the negative clinical consequences of patients with failed back surgery syndrome (FBSS). This retrospective and cross-sectional study aims to identify the risk factors associated with clinical insomnia in FBSS patients.

Methods A total of 194 patients with FBSS, who met the study inclusion criteria, were included in this analysis. The Insomnia Severity Index (ISI) was utilized to ascertain the presence of clinical insomnia (ISI score ≥ 15). Logistic regression analysis evaluates patient demographic factors, clinical factors including prior surgical factors, and psychological factors to identify the risk factors of clinical insomnia in FBSS patients.

Results After the persistent pain following lumbar spine surgery worsened, 63.4% of patients reported a change from mild to severe insomnia. In addition, 26.2% of patients met the criteria for clinically significant insomnia. In a multivariate logistic regression analysis, high pain intensity (odds ratio (OR) =2.742, 95% confidence interval (CI): 1.022 - 7.353, P=0.045), high pain catastrophizing (OR=4.185, 95% CI: 1.697 - 10.324, P=0.002), greater level of depression (OR =3.330, 95% CI: 1.127 - 9.837, P=0.030) were significantly associated with clinical insomnia. However, patient demographic factors and clinical factors including prior surgical factors were not significantly associated with clinical insomnia.

Conclusions Insomnia should be addressed as a critical part of pain management in FBSS patients with these risk factors, especially in patients with high pain catastrophizing.

Keywords: failed back surgery syndrome, insomnia, risk factors, pain severity, depression, pain catastrophizing.


Citation styles

APA
Yun, S.Y., Kim, D.H., Do, H.Y., Kim, S.H. (2017). Clinical insomnia and associated factors in failed back surgery syndrome: a retrospective cross-sectional study. International Journal of Medical Sciences, 14(6), 536-542. https://doi.org/10.7150/ijms.18926.

ACS
Yun, S.Y.; Kim, D.H.; Do, H.Y.; Kim, S.H. Clinical insomnia and associated factors in failed back surgery syndrome: a retrospective cross-sectional study. Int. J. Med. Sci. 2017, 14 (6), 536-542. DOI: 10.7150/ijms.18926.

NLM
Yun SY, Kim DH, Do HY, Kim SH. Clinical insomnia and associated factors in failed back surgery syndrome: a retrospective cross-sectional study. Int J Med Sci 2017; 14(6):536-542. doi:10.7150/ijms.18926. https://www.medsci.org/v14p0536.htm

CSE
Yun SY, Kim DH, Do HY, Kim SH. 2017. Clinical insomnia and associated factors in failed back surgery syndrome: a retrospective cross-sectional study. Int J Med Sci. 14(6):536-542.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.
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