Poor sleep is a risk factor of a range of several adverse outcomes including disabling pain conditions.

The aim of this study is to analyze the interdisciplinary outpatient pain rehabilitation program (IOPRP) treatment outcomes of chronic back and neck pain (spinal pain) with comorbidity sleep disorders.

We included 513 patients, between 1/8/14 and 28/2/16, in our IOPRP. A battery of self-reported questionnaires was completed at the beginning and end of a 16-session program; follow-up visits were scheduled three months and one year after discharge. The presence of chronic spinal pain and sleep disturbances were recorded. All subjects were separated into two groups, chronic spinal pain with sleep disturbances group 11.30% (n=58), and chronic spinal pain without sleep disturbances group 88.7% (n=455). Visual Analogue Scale (VAS) was used to evaluate pain, Insomnia Severity Index (ISI) to evaluate sleep quality, those with ISI>8 underwent polysomniography to confirm sleep disturbances, and Short-Form Survey (SF-36) to evaluate the quality of life. Both groups were treated with the IOPRP, working under international standards (Carf accreditation). Treatment included pain medication, physical and occupational therapy, cognitive and behavioral techniques for pain, sleep and stress management.

Mean age was 55.76A±0.44 years; 68.9% were females; IOPRP at baseline showed: Visual Analogue Scale (VAS) 5.66A±0.07, poor quality of life (SF36) 41.9(A±0.54), subclinical insomnia Insomnia Severity Index (ISI) 11.31A±0.26. At the end of the program, statistically significant improvement (P<0.05) was observed on VAS, SF-36 (8 domains), and ISI.

The IOPRP, working under international standards, shows improvement in sleep associated with better physical functioning and pain reduction. Interventions in the interaction between pain and sleep could potentially reduce pain and increase quality of life for patients suffering chronic pain. More studies are needed for a better understanding of this relation, pain-sleep disorders.