Sleep quality and nocturnal pain in patients with femoroacetabular impingement and acetabular dysplasia

Nisha Reddy, J. Riley Martinez, Edward Mulligan, Paul Nakonezny, Joel Wells

Research output: Contribution to journalArticle

Abstract

Background: Femoroacetabular impingement (FAI) syndrome and acetabular dysplasia (AD) are common pathologies that lead to pain in the young adult hip. Nocturnal pain in these patients is often reported, yet little is known regarding the effect of these hip pathologies on overall sleep quality. The purpose of this study was to evaluate sleep quality in patients with AD and FAI syndrome. Methods: This cross-sectional study consisted of 115 patients who complained of hip pain secondary to either FAI syndrome or AD. One hundred fifteen patients with hip pain secondary to FAI syndrome and AD were assessed using the Hip Outcome Score (HOS), Modified Harris Hip Score (mHHS), and then Hip disability and Osteoarthritis Outcome Score (HOOS). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Multiple linear regression, with adaptive LASSO variable selection, was used to assess factors associated with sleep quality. Results: Of the 115 patients, 62 had a diagnosis of FAI syndrome and 53 with AD. The mean age was 34.55 ± 11.66 (age range: 14 to 58 years), 76.52% had an ASA classification of 1 (ASA range: 1 to 3), and all Tonnis grades were either 0 or 1. The mean PSQI global score for all patients was 8.46 ± 4.35 (PSQI range: 0 to 21), indicating poor sleep quality. The adaptive LASSO-penalized least squares multiple linear regression revealed that HOOS Pain, SF-12 Role Emotional, and SF-12 Mental Health significantly predicted Sleep Quality (Adjusted R2 = 0.4041). Sleep quality improved as pain, emotional problems, and mental health improved. Conclusion: Patients with symptomatic FAI syndrome and AD have poor sleep quality. Worsening pain from a patient's hip pathology is associated with poor sleep, even prior to the onset of osteoarthrosis of the hip. Patients presenting with hip pain from FAI syndrome and AD should be screened for sleep disturbance and may benefit from a multidisciplinary treatment approach.

Original languageEnglish (US)
Article number134
JournalBMC musculoskeletal disorders
Volume21
Issue number1
DOIs
StatePublished - Feb 28 2020

Keywords

  • Femoroacetabular impingement syndrome
  • Hip dysplasia
  • Pittsburgh sleep quality index
  • Sleep quality

ASJC Scopus subject areas

  • Rheumatology
  • Orthopedics and Sports Medicine

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