Exploring the Influence of Dorsal Root Ganglion Stimulation on Sleep Behavior in Patients With Chronic Pain

Chronic pain is associated with sleep disturbances, with >70% of patients reporting clinically significant insomnia. Although dorsal root ganglion stimulation (DRGS) is an established therapy for focal neuropathic pain, its impact on sleep has not been well characterized. This study evaluated changes in patient-reported insomnia after DRGS and examined associations among sleep, pain, and functional outcomes.

We retrospectively analyzed patients from a prospective DRGS registry treated between 2018 and 2025. Patients with baseline Insomnia Severity Index (ISI) scores ≥8 and ≥one follow-up were included. Secondary outcomes included pain intensity (numerical rating scale, NRS), disability (Oswestry Disability Index, ODI), and health-related quality of life (EQ-5D). Spearman's rank correlation was used to assess relationships between ISI changes and other outcome measures.

Overall, 92 patients were included with a mean follow-up of 26.8 months. At final follow-up (range 3-60 months), mean (SD) ISI improved from 20.5 to 9.8 (-10.8 ± 9.9; -52.5%), ODI from 63.9 to 30.4 (-33.5 ± 17.7; -52.5%), NRS from 9.0 to 4.2 (-4.9 ± 2.1; -53.9%), and EQ-5D from 0.34 to 0.74 (+0.40 ± 0.21; +116.1%). The proportion of patients with moderate or severe insomnia decreased from 79% to 14%, with 59% (n = 54) reporting no clinically significant insomnia. ISI improvement correlated most with reductions in disability (ρ = 0.39; p < 0.0001) and only weakly with pain reduction (ρ = 0.19; p = 0.070).

DRGS was associated with substantial and sustained improvements in sleep among patients with chronic pain with baseline insomnia. Robust improvements were observed in ODI, EQ-5, visual analog scale, and ISI that were maintained over time. Our findings suggest that sleep-related benefits are more closely tied to functional improvement than to pain relief, supporting a broader therapeutic role for DRGS.