Perceived sleep problems after spinal cord injury: Results from a community-based survey in Switzerland

Abstract

Objective: To investigate the burden of sleep problems within the Spinal Cord injured (SCI) community with respect to the general population (GP) in Switzerland. The study further explored potential predictors for receiving treatment for sleep problems after SCI.

Design: Cross-sectional study.

Setting: SCI community in Switzerland.

Participants: Individuals diagnosed with an SCI, aged 16 years or older that permanently reside in Switzerland (N = 1549).

Interventions: Not applicable.

Outcome measures: Perceived sleep problems within the SCI community and GP. For those with sleep problems and SCI, an indicator for having received treatment was measured.

Results: 58.8% of survey participants indicated having a sleep problem; 69.4% of those with a sleep problem did not indicate receiving treatment. Amongst people living with an SCI, individuals between the ages of 46–60 years (adjusted Odds Ratio, OR = 3.07; 95% CI 1.54–6.16), participants reporting severe financial hardship (OR = 2.90; 95% CI) 1.69–4.96, and those that indicated having pain (OR = 5.62; 95% CI 3.52–8.98) were more likely to have a chronic sleep problem. In comparison to the Swiss GP, the prevalence of having a sleep problem was 18% higher among persons with SCI, with the largest discrepancy for males with paraplegia between the ages of 46–60 years (Prevalence ratio, PR = 1.28; 95% CI, 1.21–1.36).

Conclusion: Individuals with SCI experience more sleep problems compared to the Swiss GP. Findings from this study suggest that clinical screening for sleep issues targeting high risk groups is needed to reduce the large prevalence of non-treatment in individuals with SCI.

Keywords:

• Spinal cord injury
• Sleep
• Risk factors
• Benchmarking
• Self-report

Acknowledgements

The members of the SwiSCI Steering Committee are: Xavier Jordan, Fabienne Reynard (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Charly Freitag (Swiss Paraplegic Association, Nottwil); Daniel Joggi (Swiss Paraplegic Foundation, Nottwil); Hardy Landolt (Representative of persons with SCI, Glarus); Nadja Münzel (Parahelp, Nottwil); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); Christine Fekete (SwiSCI Coordination Group at Swiss Paraplegic Research, Nottwil). Furthermore, this study has been realized using the data collected by the Swiss Household Panel (SHP), which is based at the Swiss Centre of Expertise in the Social Sciences FORS.

Disclaimer statements

Contributors None.

Funding This study has been financed in the framework of the Swiss Spinal Cord Injury Cohort Study (SwiSCI, www.swisci.ch), supported by the Swiss Paraplegic Research (www.paraplegie.ch/en).

Conflicts of interest The authors have no conflict of interest to declare.

Ethics approval

The SwiSCI Community Survey underwent ethical review and formally received approval from the regional ethical committees of the following Cantons: Lucerne, Basel, Valais, and Zürich (reference numbers: 1008 [Luzern]; 37/11 [Basel]; CCVEM 015/11 [Valais]; 2012–0049 [Zürich]).