Purpose and Background. Back pain impinges upon all aspects of life, has a reported UK lifetime prevalence as high as 84% and considering approximately a third of our lives are spent asleep the paucity of research into the effect a mattress has on back pain and sleep is surprising. Mood changes, effecting an increase in pain perception, due to sleep loss may also lead to a downward spiral of increasing back pain and greater sleep loss. A controllable factor in this spiral, affecting both aspects, is the mattress but to the authors' knowledge none currently available on the market have any robust, published research to objectively support any claims made and at best being ‘endorsed’ by experts. This may lead to possible misinterpretation of efficacy and leave professionals at a loss with what to advise when questioned. Methods and Data collection. Method:. A three month, randomised, controlled, double blind crossover field study is proposed to take place in the participants own homes, ensuring the most natural sleep environment. Data collection:. Three 28 day phases. 1 - Baseline data, participants sleeping on their own mattress. 2 - Random allocation of mattresses, half allocated test and half control. 3 - Crossover of test and control mattress. Subjective measures of back pain and sleep quality will be collected utilising a daily sleep diary and visual analogue scales. Objective measures of sleep quality using activity monitors during sleep. Conclusion. Minimal evidence is available suggesting the optimal sleep surface for people with back pain. This research hopes to generate evidence to help this group with mattress selection. To confirm: this abstract has not previously been published in whole or part nor has it been presented previously at a national meeting. Conflicts of interest: All mattresses will be designed in conjunction with and provided by Innovative Health Organisation Caerphilly. Sources of funding: This work is part-funded by the European Social Fund (ESF) through the European Union's Convergence programme administered by the Welsh Government and is in conjunction with the Knowledge Economy Skills Scholarship (KESS) project

Background and purpose. Sleep disturbance is frequently reported by people with chronic low back pain (CLBP >12 weeks), but there is limited knowledge of their sleep quality compared to healthy people. While disturbed sleep influences patients' mood, quality of life and recovery, few studies have comprehensively investigated sleep in CLBP. This study investigated differences in sleep profiles of people with CLBP, compared to age- and gender matched controls over seven consecutive nights. Methods. Thirty-two consenting subjects (n=16 with CLBP, n=16 matched controls), aged 24-65 years (43.8% male) underwent an interview regarding sleep influencing variables (e.g. mattress firmness, caffeine consumption), completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Pittsburgh Sleep Diary, SF36-v2, Hospital Anxiety and Depression Scale, and CLBP measures (i.e. Oswestry Disability Index and Numerical Pain Scales), recorded seven consecutive nights of sleep in their home using actigraphy, and completed a Devices Utility Questionnaire. Results. Compared to controls, people with CLBP had significantly disturbed sleep on self-report measures (PSQI mean (SD) 10.9 (4.2); ISI mean 13.7 (7.6); Sleep Diary; p<0.001), but no significant differences on objective actigraphy (p>0.05). Actigraphy was found to be a user friendly sleep measure for use in the home environment (84.6%, n=11 CLBP; 73.3%, n=11 control). Conclusions. Self-rated sleep using a valid instrument should be routinely measured in LBP research and clinical practice. Further investigation of the relationship between patients' perception of their sleep quality and its objective measurement is warranted before actigraphy could be recommended as an objective outcome measure for the evaluation of sleep in this population

Background and purpose. Sleep disturbance is a prevalent symptom in people with chronic low back pain (CLBP >12 weeks), but there is currently no knowledge of the effectiveness of physiotherapy for this problem. This study evaluated the feasibility of a randomised controlled trial (RCT) exploring the effects of physiotherapy on sleep disturbance in CLBP [Current controlled trial ISRCTN 54009836]. Methods. A sample of 60 consenting patients with CLBP [23 M, 37 F; mean (SD) age = 44.93 (13.41) years] were recruited in Beaumont Hospital, Dublin and randomly allocated to one of three groups [supervised exercise class (SEC), walking programme (WP) and usual physiotherapy (UP)] in a concealed manner. The main outcomes were sleep quality, functional disability, pain, and quality of life at baseline, 3 and 6 months. Results. The majority of participants reported sleep disturbance (95%, n=57) and related it to their LBP (81%, n=46). At 3 months compared with the WP and SEC, participants in the UP group displayed greater reductions in average low back pain VAS (WP d=.97, SEC d=.86) and greater improvements in sleep disturbance (Pittsburgh Sleep Quality Index WP d=.59, SEC d=.29; Insomnia Severity Index WP d= .56, SEC d= .24). However, compared to UP there were greater improvements in functional disability (SF-36 PCS) in the WP (d= .32) and the SEC (d= .21). Conclusions. The results provide preliminary evidence of the effects of physiotherapy on sleep disturbance in CLBP, demonstrate the feasibility of undertaking a RCT in this field and inform refinement of the study protocol for a fully powered trial