Sleep Physiology in Spine Disease: A Comparative Study of Cervical and Lumbar Patients.

Study Design: Prospective cohort study.

Objective: We aim to compare Fitbit-collected sleep metrics between patients with cervical and lumbar spine diseases and explore correlations between these metrics and patient-reported outcome measures (PROMs) and self-reported sleep.

Summary Of Background Data: Pain, fatigue, and postural problems often lead to sleep disturbances in patients with spine disease. However, it remains unclear whether such sleep disturbances impact patients with cervical and lumbar disease differently. Differentiating sleep physiology between cervical and lumbar patients may provide insights into sleep disturbance pathophysiology and highlight directions for future research and clinical care.

Methods: Patients aged 21-85 years undergoing surgery for degenerative spine disease were included. Participants were passively monitored before surgery using Fitbit trackers. Raw Fitbit sleep data were extracted at the minute level and transformed into daily features, such as time taken to fall asleep, duration asleep, number of waking episodes, and others. Preoperative PROMs included PROMIS pain interference, physical function, and pain intensity. Self-reported sleep quality was assessed using sleep-related questions from the Oswestry Disability Index and Neck Disability Index. An Independent t test was used to test for differences in sleep metrics between cervical and lumbar patients, and Spearman correlation was carried out between sleep metrics and PROMs.

Results: Our study included 155 patients, with a mean (SD) age of 59 (11.8) years, and 53% were female. Twenty-seven and 128 individuals were in cervical and lumbar cohorts, respectively. Cervical patients had greater self-reported sleep disturbances, though no significant differences were found in Fitbit sleep measures. Stronger correlations were found between sleep and pain measures in cervical patients.

Conclusion: Our study suggests that cervical and lumbar spine patients have similar objective sleep metrics, but cervical patients report greater sleep disturbances, more closely linked to pain than in the lumbar cohort. Further research is needed to clarify the relationship between sleep and spine pathology.

Level Of Evidence: Level III.