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Relationship, differences, and agreement between objective and subjective sleep measures in chronic spinal pain patients with comorbid insomnia : a cross-sectional study

Thomas Bilterys, Eveline Van Looveren, Anneleen Malfliet, Jo Nijs, Mira Meeus (UGent) , Lieven Danneels (UGent) , Kelly Ickmans, Barbara Cagnie (UGent) , Dorien Goubert (UGent) , Maarten Moens, et al.
(2023) PAIN. 164(9). p.2016-2028
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Abstract
Sleep disturbances are one of the most frequent reported problems in people with nonspecific chronic spinal pain (nCSP) and presents an additional treatment challenge. Interventions targeting sleep problems are mainly based on subjective sleep complaints and do not take objective sleep into consideration. The aim of this cross-sectional study was to evaluate the relationship and conformity between self-reported and objectively measured sleep parameters (ie, questionnaire vs polysomnography and actigraphy). The baseline data of 123 people with nCSP and comorbid insomnia who are participating in a randomized controlled trial were analyzed. Pearson correlations were used to investigate the relationship between objective and subjective sleep parameters. Differences between objective and subjective sleep parameters were analyzed using t tests. Bland-Altman analyses were performed to quantify and visualize agreement between the different measurement methods. Except for the significant moderate correlation between perceived time in bed (TIB) and actigraphic TIB (r = 0.667, P < 0.001), all other associations between subjective and objective measures were rather weak (r < 0.400). Participants underestimated their total sleep time (TST) (mean difference [MD] = -52.37 [-67.94, -36.81], P < 0.001) and overestimated sleep onset latency (SOL) (MD = 13.76 [8.33, 19.20], P < 0.001) in general. The results of this study suggest a discrepancy (differences and lack of agreement) between subjective and objective sleep parameters in people with nCSP and comorbid insomnia. No or weak associations were found between self-reported sleep and objectively measured sleep. Findings suggest that people with nCSP and comorbid insomnia tend to underestimate TST and overestimate SOL. Future studies are necessary to confirm our results.
Keywords
Self-report, Actigraphy, Polysomnography, Sleep assessment, Chronic back pain, Chronic neck pain, Chronic spinal pain

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MLA
Bilterys, Thomas, et al. “Relationship, Differences, and Agreement between Objective and Subjective Sleep Measures in Chronic Spinal Pain Patients with Comorbid Insomnia : A Cross-Sectional Study.” PAIN, vol. 164, no. 9, 2023, pp. 2016–28, doi:10.1097/j.pain.0000000000002901.
APA
Bilterys, T., Van Looveren, E., Malfliet, A., Nijs, J., Meeus, M., Danneels, L., … Mairesse, O. (2023). Relationship, differences, and agreement between objective and subjective sleep measures in chronic spinal pain patients with comorbid insomnia : a cross-sectional study. PAIN, 164(9), 2016–2028. https://doi.org/10.1097/j.pain.0000000000002901
Chicago author-date
Bilterys, Thomas, Eveline Van Looveren, Anneleen Malfliet, Jo Nijs, Mira Meeus, Lieven Danneels, Kelly Ickmans, et al. 2023. “Relationship, Differences, and Agreement between Objective and Subjective Sleep Measures in Chronic Spinal Pain Patients with Comorbid Insomnia : A Cross-Sectional Study.” PAIN 164 (9): 2016–28. https://doi.org/10.1097/j.pain.0000000000002901.
Chicago author-date (all authors)
Bilterys, Thomas, Eveline Van Looveren, Anneleen Malfliet, Jo Nijs, Mira Meeus, Lieven Danneels, Kelly Ickmans, Barbara Cagnie, Dorien Goubert, Maarten Moens, Liesbet De Baets, Wouter Munneke, and Olivier Mairesse. 2023. “Relationship, Differences, and Agreement between Objective and Subjective Sleep Measures in Chronic Spinal Pain Patients with Comorbid Insomnia : A Cross-Sectional Study.” PAIN 164 (9): 2016–2028. doi:10.1097/j.pain.0000000000002901.
Vancouver
1.
Bilterys T, Van Looveren E, Malfliet A, Nijs J, Meeus M, Danneels L, et al. Relationship, differences, and agreement between objective and subjective sleep measures in chronic spinal pain patients with comorbid insomnia : a cross-sectional study. PAIN. 2023;164(9):2016–28.
IEEE
[1]
T. Bilterys et al., “Relationship, differences, and agreement between objective and subjective sleep measures in chronic spinal pain patients with comorbid insomnia : a cross-sectional study,” PAIN, vol. 164, no. 9, pp. 2016–2028, 2023.
@article{01HT5DW7YFZH5DVSJ75NZ60Z0W,
  abstract     = {{Sleep disturbances are one of the most frequent reported problems in people with nonspecific chronic spinal pain (nCSP) and presents an additional treatment challenge. Interventions targeting sleep problems are mainly based on subjective sleep complaints and do not take objective sleep into consideration. The aim of this cross-sectional study was to evaluate the relationship and conformity between self-reported and objectively measured sleep parameters (ie, questionnaire vs polysomnography and actigraphy). The baseline data of 123 people with nCSP and comorbid insomnia who are participating in a randomized controlled trial were analyzed. Pearson correlations were used to investigate the relationship between objective and subjective sleep parameters. Differences between objective and subjective sleep parameters were analyzed using t tests. Bland-Altman analyses were performed to quantify and visualize agreement between the different measurement methods. Except for the significant moderate correlation between perceived time in bed (TIB) and actigraphic TIB (r = 0.667, P < 0.001), all other associations between subjective and objective measures were rather weak (r < 0.400). Participants underestimated their total sleep time (TST) (mean difference [MD] = -52.37 [-67.94, -36.81], P < 0.001) and overestimated sleep onset latency (SOL) (MD = 13.76 [8.33, 19.20], P < 0.001) in general. The results of this study suggest a discrepancy (differences and lack of agreement) between subjective and objective sleep parameters in people with nCSP and comorbid insomnia. No or weak associations were found between self-reported sleep and objectively measured sleep. Findings suggest that people with nCSP and comorbid insomnia tend to underestimate TST and overestimate SOL. Future studies are necessary to confirm our results.}},
  author       = {{Bilterys, Thomas and Van Looveren, Eveline and  Malfliet, Anneleen and  Nijs, Jo and Meeus, Mira and Danneels, Lieven and  Ickmans, Kelly and Cagnie, Barbara and Goubert, Dorien and  Moens, Maarten and  De Baets, Liesbet and  Munneke, Wouter and  Mairesse, Olivier}},
  issn         = {{0304-3959}},
  journal      = {{PAIN}},
  keywords     = {{Self-report,Actigraphy,Polysomnography,Sleep assessment,Chronic back pain,Chronic neck pain,Chronic spinal pain}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{2016--2028}},
  title        = {{Relationship, differences, and agreement between objective and subjective sleep measures in chronic spinal pain patients with comorbid insomnia : a cross-sectional study}},
  url          = {{http://doi.org/10.1097/j.pain.0000000000002901}},
  volume       = {{164}},
  year         = {{2023}},
}
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