Student: Ceri Ann Jones
Company: The Innovative Health Organisation
Academic Supervisor: Pete McCarthy & Andrew Heusch
Purpose
The paucity of research in to sleep surfaces, sleep quality and back problems is surprising as we spend approximately a third of our lives asleep and 84% of the UK population will be afflicted with low back pain at some point in their lives.
Complications of sleep deprivation are far reaching: from reduced immune system efficiency, cognitive problems and metabolic issues (i.e., raised cortisol levels can increase risk of obesity, type two diabetes and heart disease). Many studies have shown a correlation between daytime fatigue and an increase in accidents.
To the authors knowledge no mattress currently on the market has any robust, published research on its effect on sleep and back pain to objectively support claims made. The majority of mattresses are ‘endorsed’ by professionals leading to possible misinterpretation of efficacy. For this reason an objective assessment of mattress design in relation to this group would be beneficial.
Methods
A four week pilot study with six participants will initially be performed to determine power and improve the delivery of the methodology for the main study.
A three month, double blind randomised controlled crossover study will take place in the participants own homes to ensure the most natural sleep environment. Data collection will be in three phases:
Phase 1 – participant evaluates own mattress over 28 days, baseline data
Phase 2 – new mattresses delivered and evaluated over 28 days
Phase 3 – crossover, final mattress delivered and evaluated over 28 day period
Data collection
Subjective and objective measures, comprising a sleep diary, completed daily on awakening, consisting of visual analogue scales (VAS) on sleep factors and back discomfort. Collection of objective measures will involve the wearing of an activity monitor whilst sleeping.
Participant Selection
Adverts placed in selected chiropractic clinics for volunteers. Inclusion criteria: chronic or chronic recurrent, non specific low back problems and, availability for the duration of the twelve week trial. Exclusion criteria: red flags, neuropathic pain, surgical appointment, excessive stimulant use and not sleeping in own bed for more than three nights a week. Participants will be asked to complete several questionnaires to assess pain, disability and sleeping pattern.
Ethical approval for this study was granted by the University of South Wales.
Data Analysis
Anthropometric data will be compared to all variables. PSQI and ESS, performed at start and end, daily sleep diary and actigraphy fortnightly averages, will be used for analysis. SPSS statistical package will be utilised for analysis of the data inclusive of ANOVA and appropriate post-hoc testing.
Conclusion
There is minimal evidence to suggest the optimal sleep surface. This research hopes to generate evidence to help those with back problems when selecting mattresses.
