Changes in Sleep Quality and Treatment Outcomes in Patients with Musculoskeletal Pain Managed in Primary Care...

To investigate the association between change in sleep quality over a 3-month period and the overall perceived effect of treatment, pain intensity, and health-related quality of life up to 12-month follow-up.

This longitudinal study included 997 individuals (mean age 49.7 years, 72.1% women) with musculoskeletal pain who sought care from a physiotherapist in primary health care in Norway. Postoperative patients were excluded. We used a Generalized Estimating Equation (GEE) model to calculate adjusted risk ratios (RRs) for the probability of a positive treatment outcome at 6 and 12 months, associated with categories of good and poor sleep reported at first encounter and after three months.

Compared with those who reported poor sleep quality over the first three months, those who reported improved sleep quality had a greater probability for a positive perceived effect of treatment (relative risk 1.66; 95% confidence interval [CI]:1.37-2.00), low pain intensity (RR:1.71; 95% CI:1.34-2.19), and high health-related quality of life (RR:2.06; 95% CI:1.55-2.75) at 12 months. Those who reported good sleep quality over the 3-month period had similar probabilities of positive treatment outcomes as those who reported improved sleep quality.

Individuals who reported improved sleep quality during the first three months after the first consultation with a physiotherapist in primary care had a substantially higher probability of positive treatment outcomes up to 12 months, compared with those who had poor sleep.