Risk Factors and Prevalence of Sleep Disturbance in Degenerative Cervical Myelopathy.

Abstract

Sleep disturbances, especially those lasting more than one hour, are under-researched in patients with degenerative cervical myelopathy (DCM). This study aims to investigate the prevalence and risk factors for such disturbances in DCM patients undergoing decompression surgery and to identify factors contributing to poor postoperative improvement. A multicenter retrospective observational study was conducted on consecutive patients diagnosed with DCM who underwent cervical decompression surgery between April 2018 and August 2022. The Neck Disability Index sleep component was assessed at baseline and 12 months postsurgery. Univariate and multivariable logistic regression analyses were used to identify risk factors for persistent sleep disturbances and poor improvement. Of the 1912 patients included, 54.8% reported sleep disturbances, with 33.0% experiencing disturbances of more than one hour at baseline. Multivariable analysis identified male sex, high body mass index, high Numerical Rating Scale for arm pain, high Neck Disability Index, and high Core Outcome Measures Index Neck as significant risk factors for sleep disturbances. At 12 months, 35.2% of these patients continued to experience significant sleep issues. The presence of ossification of the posterior longitudinal ligament and high baseline Numerical Rating Scale for neck pain were significant predictors of poor improvement. The study highlights that ossification of posterior longitudinal ligament and high baseline neck pain are significant risk factors for persistent sleep disturbances postsurgery in DCM patients. Early identification and targeted interventions may be necessary to improve outcomes.