Skip to content

Nightmare disorder and low back pain in veterans: cross-sectional association and effect over time.

Kenneth A Taylor, Skai W Schwartz, Amy C Alman, Adam P Goode, Getachew A Dagne, Yuri V Sebastião, Philip R Foulis

SLEEP Advances September 10, 2022 DOI: 10.1093/sleepadvances/zpac030 (opens in new tab)

Read Full Text
Relevant Not relevant

Study at a glance

AI-extracted from the abstract
Characteristics Retrospective cohort study Cross-sectional Peer reviewed
Sample size 15,983
Population US military veterans in the Veterans Health Administration, with oversampling of those with nightmare disorder
Duration Up to 60-month follow-up
Topics Dreaming
Keywords Pain Epidemiology Psychiatric disorders Nightmares Behavioral sleep medicine
Key findings Nightmare disorder was associated with low back pain in veterans, with adjusted odds ratios of 1.35 within 6 months and 1.21 within 12 months of diagnosis. The effect on time to low back pain was strongest in the first months after diagnosis (hazard ratios 1.27 at 3 months, 1.23 at 6 months, 1.19 at 9 months) and approximated the null at 12 months (1.10) and beyond. The authors suggest improved screening for nightmare disorder may help predict or reduce future back pain risk.

Abstract

Low back pain (LBP) disproportionately impacts US military veterans compared with nonveterans. Although the effect of psychological conditions on LBP is regularly studied, there is little published to date investigating nightmare disorder (NMD) and LBP. The purpose of this study was to (1) investigate whether an association exists between NMD and LBP and (2) estimate the effect of NMD diagnosis on time to LBP. We used a retrospective cohort design with oversampling of those with NMD from the Veterans Health Administration (n = 15 983). We used logistic regression to assess for a cross-sectional association between NMD and LBP and survival analysis to estimate the effect of NMD on time to LBP, up to 60-month follow-up, conditioning on age, sex, race, index year, Charlson Comorbidity Index, depression, anxiety, insomnia, combat exposure, and prisoner of war history to address confounding. Odds ratios (with 95% confidence intervals [CIs]) indicated a cross-sectional association of 1.35 (1.13 to 1.60) and 1.21 (1.02 to 1.42) for NMD and LBP within 6 months and 12 months pre- or post-NMD diagnosis, respectively. Hazard ratios (HRs) indicated the effect of NMD on time to LBP that was time-dependent-HR (with 95% CIs) 1.27 (1.02 to 1.59), 1.23 (1.03 to 1.48), 1.19 (1.01 to 1.40), and 1.10 (0.94 to 1.29) in the first 3, 6, 9, and 12 months post-diagnosis, respectively-approximating the null (1.00) at >12 months. The estimated effect of NMD on LBP suggests that improved screening for NMD among veterans may help clinicians and researchers predict (or intervene to reduce) risk of future back pain.

Comparable studies

Other observational and cohort studies on dreaming, most cited first.

Study Year Design Participants
Lucid Dreaming: a State of Consciousness with Features of Both Waking and Non-Lucid Dreaming Student volunteers trained to become lucid and signal lucidity with horizontal eye... 2009 Observational study n = 6
Nightmare Prevalence, Nightmare Distress, and Self-Reported Psychological Disturbance Young adults with a mean age of 20 years 2002 Prospective observational study n = 116
Long-term effects of extreme situational stress on sleep and dreaming Survivors of traumatic events who complained of sleep disturbances, compared with... 1987 Case-control study n = 11
The relationship of nightmare frequency and nightmare distress to well‐being Adults who reported dreams 2004 Observational cohort n = 147
Dreaming in NREM Sleep: A High-Density EEG Study of Slow Waves and Spindles Healthy human subjects 2018 Observational cohort n = 14

Citations in the library

Cites 4

Related reading

Explore topics

Dreaming Addiction Anxiety Depression