Mustafa BULUT, Fırat SEYFETTİNOĞLU
Journal of Turkish Spinal Surgery - 2026;37(4):148-154
Objective: Sleep impairment frequently accompanies chronic neck pain, but its relationship with cervical sagittal radiographic morphology remains unclear. To investigate associations between sleep quality, neck-specific disability, and cervical sagittal alignment in adults with chronic neck pain. Materials and Methods: This retrospective cross-sectional study included 86 adults evaluated at a single institution for neck pain lasting at least 6 months. Sleep quality and functional disability were assessed using the Pittsburgh sleep quality index (PSQI) and neck disability index (NDI), respectively. A PSQI score above 5 was defined as poor sleep quality. Lateral cervical radiographs were used to measure C2-C7 lordosis, C7 slope, T1 slope, and T1 slope-C2-C7 Cobb angle (T1S-CL mismatch). Analyses included group comparisons, Spearman correlation, univariable logistic regression, multivariable logistic regression, and multivariable linear regression. Results: Forty-five patients (52.3%) had poor sleep quality. They had a smaller median C2-C7 lordosis and a higher median NDI score compared with patients with good sleep quality. Higher PSQI scores correlated with lower C2-C7 lordosis and higher C7 slope, T1S-CL mismatch, NDI score, and symptom duration. In multivariable linear regression, NDI remained positively associated with PSQI after adjustment. No evaluated variable remained independently associated with poor sleep quality in the multivariable logistic regression model. Conclusion: Poor sleep quality was associated with greater neck-related disability and reduced cervical lordosis in adults with chronic neck pain. Joint assessment of sleep quality, disability, and cervical sagittal alignment may enable broader clinical characterization. These findings should be interpreted cautiously because the study was cross-sectional.
