Patterns of Sleep in Patients with Spinal Cord Stimulation

Richard Rosenthal1 Lilly Chen2, Kerry Bradley2, Nitzan Mekel-Bobrov2

1Nexus

Pain Care, Provo, Utah. 2Boston Scientific Neuromodulation, Valencia, CA

Introduction
Patients with chronic pain typically report poor sleep patterns: fewer hours of sleep, poor sleep quality, and negative correlation of sleep duration and quality to pain severity [1]. One anecdotally-reported benefit of receiving spinal cord stimulation (SCS) to treat chronic intractable pain of the trunk and limbs is improved sleep. Few published reports of SCS outcomes have focused on sleep.

Results
N: 46 subjects (31 predominant low-back pain and 15 predominant leg pain) were interviewed

Gender: 24 F / 22 M
Age: 61.9 14.7 (24 88) years-old Implant Duration: 16.5 5.4 months Pain Relief: mean overall pain relief was 56 25% (p 0.0001). Daily Sleep Duration: mean 7.2 2.5 hours per 24hour period. Average Sleep Quality: 5.6 2.5 (0-10 scale)

We report here our results on sleep patterns in patients utilizing successful SCS.

Methods
This study is based on an exploratory analysis of clinical data collected in a retrospective consecutive case-series of sleep patterns in chronic pain patients treated with the Precision PlusTM SCS system (Boston Scientific, Valencia, CA). A researcher uninvolved in patient care conducted scripted telephone interviews with an inclusive, sequential series of patients implanted with Precision Plus SCS systems at a single pain management practice (Nexus Pain Care). Questions were directed for subject demographics and patient recall of: Pain Relief assessments Daily Sleep Duration (at night, during day) Sleep Quality

Duration of Sleep showed a positive correlation with Sleep Quality (r = 0.52, p = 0.0009). Pain Relief rating was also statistically significantly correlated to Sleep Quality (r = 0.40, p = 0.0056).

Conclusions
This retrospective consecutive case series suggests that chronic pain patients, including patients with predominant low-back pain, reported normal sleep patterns following treatment with SCS.

Further prospective and multi-center study is recommended.

References
1. Haythorthwaite JA, Hegel MT, Kerns RD. Development of a sleep diary for chronic pain patients. J Pain Symptom Managemt 1991; 6: 65-72
Presented at: 6th World Congress of the World Institute of Pain, Miami Beach, FL, February 4-6, 2012. Study sponsored by Boston Scientific Corporation.