Objective:

To evaluate the association between nocturnal pain, sleep quality, pain intensity, and functional impairment in patients with elbow disorders.

Approach:

• Study Design: Enrolled 664 adult patients with common elbow disorders at five orthopedic surgery centers from December 2020 to May 2024.
• Assessment Tools: Patients completed validated outcome measures including the Pittsburgh Sleep Quality Index (PSQI), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, Single Assessment Numeric Evaluation-Elbow, and a numeric rating scale for pain.
• Exclusion Criteria: Excluded patients with previous elbow surgery, diagnosed sleep disorders, mood disorders, recent fractures, substance abuse, or other musculoskeletal conditions affecting sleep.
• Data Analysis: Evaluated sleep quality, pain intensity, and functional impairment across diagnostic subgroups.

Key Findings:

• 81% of patients reported nocturnal pain.
• Mean PSQI score was 7, indicating poor sleep quality.
• Lateral epicondylar pain accounted for 66% of cases.
• Poor sleep quality was associated with greater upper extremity disability and higher pain intensity.
• No significant differences in PSQI scores among different elbow pathologies.

Interpretation:

Poor sleep quality in elbow disorder patients is more closely related to pain and functional impairment than to specific diagnoses.

Limitations:

• Sleep quality assessed via self-reported questionnaire, introducing potential reporting bias.
• Causality could not be established.
• Exclusion of patients with known mood or sleep disorders may limit generalizability.
• Possible inclusion of isolated cases of elbow instability despite exclusion criteria.

Conclusion:

Future studies should assess the impact of treatments on sleep quality alongside pain and function in elbow disorder management.

Sources:

• Journal of Orthopaedics and Traumatology