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Can sleep quality or daytime sleepiness be associated with physical disability in older adults? A cross-sectional study


: Low back pain is a major cause of disability worldwide. Reports in the literature show that 60% of patients with low back pain have sleep complaints. At the moment, the relationship between sleep and disability in older adults remains unclear.


To investigate whether sleep quality is associated with disability in older adults with low back pain.


The study was designed as cross-sectional. Inclusion criteria for participation were age over 60 years, low back pain in the last 12 weeks or at the moment of the interview, and absence of cognitive impairment. The questionnaires applied were Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and the Roland Morris Questionnaire. To perform the statistical analysis, the multivariate regression model was applied and adjusted for covariates.


The sample consisted of 225 older adults with low back pain. The average (standard deviation) of sleep quality was 10.33 (3.24) points in the Pittsburg Sleep Quality Index questionnaire, the average daytime sleepiness scale of 5.01 (3.37), and the mean disability questionnaire in this population was 10.92 (6.6). After the covariate-controlled multivariate linear regression analysis, the final model showed that the daytime sleepiness scale was associated with disability in patients with low back pain β=0.20 (0.001 to 0.40) and p=0.04, meaning that, at each point on the sleepiness scale, patients increased 0.20 points on the disability questionnaire.


Our results suggest that daytime sleepiness was associated with an increase in physical disability in older people with low back pain. Future studies should investigate if there is a relationship of causality.


Older adults, disability, sleep, low back pain


Área Clínica


Sabrina Dias de Oliveira, Rafael Zambelli Pinto, Viviane Akemi Kakazu, Ygor Luciano Matos, Marcia Franco, Rubens Faria de Negrão, Cynthia Gobbi, Sergio Tufik, Monica Levy Andersen, Priscila Kalil Morelhão