Exploring the Interplay of Sleep Disturbance, Low Back Pain and Health Care Experiences: A Mixed Methods Study

To explore the attitudes and experiences of people with chronic low back pain (LBP) on sleep, health care, and digital health.

Participants completed a survey about LBP, sleep, health care, and digital health. All data collected was self-reported by participants. Survey completers were invited for semi-structured interviews comprising open-ended questions exploring LBP and sleep interplay, health care experiences, and digital health preferences. Interviews were analyzed using a thematic framework approach.

Six-hundred and sixty-nine participants completed the survey. n = 501 female, mean age = 56.7 ± 14.4 years. Most participants (90%) reported LBP-related sleep disturbance. More than half (61%) were not satisfied with their current LBP-related health care Sixty-one percent of participants were willing to use a sleep-specific digital health intervention (DHI) if recommended by a health care professional. Interviews (n = 26) revealed three themes: (i) living with LBP and poor sleep, (ii) health-seeking behaviors, and (iii) implementing sleep and back pain DHIs. Participants were concerned with the legitimacy of non-health professional advice and preferred evidence-based DHIs.

Sleep disturbance and health care dissatisfaction was highly prevalentin individuals with chronic LBP. Participants were willing to use evidence-based self-directed DHIs for LBP and sleep disturbance management but wanted clinical authority. These findings reveal opportunities for clinical implementation and intervention studies for individuals with chronic LBP and sleep disturbance.