M. Alshehri1, G. Algudairi2, E. Aleisa3, M. Alrwaily4
1Jazan University, Jazan, Saudi Arabia, 2Security Forces Hospital, Department of Physical Therapy, Riyadh, Saudi Arabia, 3King Saud University, Department of Rehabilitation, Riyadh, Saudi Arabia, 4West Virginia University, Department of Physical Therapy and Rehabilitation Science, Morgantown, United States
Background: Low back pain (LBP) is a prevalent disorder in Saudi Arabia. Many females with LBP who are referred to physical therapy clinics are also found to have Pelvic Floor Dysfunction (PFD) that affect their quality of life.
Purpose: We aimed to 1) investigate the association between sleep quality and PFD in women with LBP and 2) establish criterion at which PFD is related to poor sleep quality.
Methods: In this cross-sectional study, we collected demographics and Arabic validated questionnaires including the pelvic floor distress inventory (PFDI‑20) and Pittsburgh Sleep Quality Index (PSQI), with high scores on these questionnaires indicate worse symptoms. We included Arabic speaking women with chronic LBP who were referred to several hospitals in Riyadh, Saudi Arabia. Two hundred and twenty two participants were involved in the study (age 46.77±7.70 and body mass index (BMI) 31.63±4.69). Generalized linear model was used to assess the association between PSQI (dependent variable) and PFDI‑20 after controlling for age, BMI, and menopausal and sexual status. Also, area under the curve (AUC) was used to determine the optimum cutoff score in PFDI-20 related to PSQI score. The significant level was set at .05.
Results: Among women with chronic LBP, there were 33.3% with post-menopausal status and 26.6% with no active sexual status. Most of the sample had high score on the PSQI (72.9%) (i.e., >5 score on PSQI). The average of the PFDI-20 was 128.90±34.22. After controlling for covariates, there was significant association between PSQI and PFDI-20 (β = .04, P < 0.001). In addition, sextual status was significantly associated with PSQI and PFDI-20 (β = -1.24, P=0.03). The range of the PFDI-20 was between 75 and 258.33 and the cutoff score for PFDI-20 that differentiate poor sleep quality (>4 on PSQI) was 162 (sensitivity 0.96; specificity 0.81), and an AUC of 0.71.
Conclusion(s): The data suggest high prevalence of poor sleep quality in women with chronic LBP and PFD. The association between poor sleep quality and worse symptoms of PFD might be bidirectional in which future studies are needed to investigate the complex relationship between these factors.
Implications: Because poor sleep quality and PFD are associated in women with chronic LBP, clinicians/physical therapists may need to screen for sleep quality and PFD to investigate factors that might have negative influence on the treatment plans.
Funding, acknowledgements: Not funded
Keywords: Women's Health, Sleep, Pelvic Floor Dysfunction
Topic: Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? Yes
Institution: King Fahad Medical City
Committee: King Fahad Medical City's Review Board
Ethics number: 10.4103/UA.UA_123_18
All authors, affiliations and abstracts have been published as submitted.
