Sleep Disturbances Risk Factors in Degenerative Cervical Myelopathy Patients

Introduction: Sleep plays a critical role in homeostatic regulation. Sleep disturbances can negatively impact quality of life and increase susceptibility to illness. Chronic pain is a well-established risk factor for sleep disruption and is especially relevant in patients with degenerative spinal conditions. Existing studies suggest that Degenerative Cervical Myelopathy (DCM) patients often experience sleep disturbances, possibly due to spinal cord compression and pain. However, most research is limited to small, single-center studies, creating a need for broader analysis.

Methods: We use the Merative Explorys Dataset, focusing on electronic health record (EHR) data of patients diagnosed with DCM and sleep disorders, identified through ICD codes. Comorbidities were also identified using ICD codes and included conditions such as depression/bipolar disorder, chronic pulmonary disease, migraine, osteoarthritis, hypertension, malignancy, diabetes, and cerebrovascular disease. Patient demographic information—age, race, sex, and body mass index (BMI)—was also extracted and included as covariates. Logistic regression analyses were performed to evaluate the association between each comorbidity and the risk of sleep disturbance.

Results: In an analysis of 47,000 patients with DCM, we identified several significant predictors of sleep disturbance, including higher BMI (OR 1.05, 95% CI: 1.05–1.06), depression/bipolar disorder (OR 1.65, 95% CI: 1.56–1.74), chronic pulmonary disease (OR 1.26, 95% CI: 1.20–1.33), migraine (OR 1.32, 95% CI: 1.22–1.43), and hypertension (OR 1.16, 95% CI: 1.10–1.23). Notably, osteoarthritis and malignancy were inversely associated with sleep disturbance.

Conclusion : Our findings expand upon previous research by demonstrating the multifactorial nature of sleep disturbances in DCM. The strong association with BMI and respiratory conditions suggests a role for sleep-disordered breathing in this population. Additionally, the identification of migraines as a risk factor highlights the need for multidisciplinary management. Addressing modifiable risk factors such as BMI and mental health is essential for improving sleep quality in DCM patients.