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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 
 International Journal of Medical Sciences, Vol.14(6) : 536-542, 2017 
Journal Title
 International Journal of Medical Sciences 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Back Pain/complications ; Back Pain/epidemiology ; Back Pain/physiopathology* ; Back Pain/surgery ; Chronic Pain/complications ; Chronic Pain/epidemiology ; Chronic Pain/physiopathology* ; Chronic Pain/surgery ; Cross-Sectional Studies ; Failed Back Surgery Syndrome/complications ; Failed Back Surgery Syndrome/epidemiology ; Failed Back Surgery Syndrome/physiopathology* ; Female ; Humans ; Male ; Middle Aged ; Pain Management/adverse effects ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Sleep Initiation and Maintenance Disorders/complications ; Sleep Initiation and Maintenance Disorders/epidemiology ; Sleep Initiation and Maintenance Disorders/physiopathology*
depression ; failed back surgery syndrome ; insomnia ; pain catastrophizing ; pain severity ; risk factors
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.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Shin Hyung(김신형) ORCID logo https://orcid.org/0000-0003-4058-7697
Do, Hae Yoon(도해윤) ORCID logo https://orcid.org/0000-0003-3170-8207
Yun, Soon Young(윤순영)
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