Less Pain, Better Sleep? The Effect of a Multidisciplinary Back Pain App on Sleep Quality in Individuals Suffering from Back Pain – a Secondary Analysis of App User Data

PURPOSE: Mobile health solutions are finding their way into health systems. The Kaia app has been shown to be able to reduce back pain in two studies. Since pain often comes along with disturbed sleep and both symptoms are strongly related we investigated whether the Kaia app training is associated with improved sleep quality. METHODS: User data of individuals with back pain were collected in two app versions (cohort 1: N = 180; cohort 2: N = 159). We analyzed the ratings of sleep quality and pain intensity on a 11-point numeric ratings scale (NRS; 0–10) both at the beginning of usage (baseline: BL) and on the individual last day of usage (follow-up: LU) within a 3-month training program. RESULTS: In both cohorts, we found a significant reduction in pain intensity from BL to LU (cohort 1: M(BL) = 4.80; SD = 1.59 to M(LU) = 3.75; SD = 1.76, Δ(pain) = –1.04; SD = 2.12; t(158) = 6.207; p<.001/cohort 2: M(BL) = 4.20; SD = 1.98 to M(LU) = 3.65; SD = 1.78; Δ(pain) = –0.50; SD = 2.04; t(147) = 3.001; p = 0.003) and a significant improvement of sleep quality (cohort 1: M(BL) = 5.76; SD = 2.12 to M(LU) = 6.56; SD = 1.72; Δ(sleep) = t(158) = 4.310; p < 0.001/cohort 2: M(BL) = 6.08; SD = 2.08 to M(LU) = 6.76; SD = 1.55; Δ(sleep) = 0.67; SD = 2.13; sleep: t(147) = 3.825; p < 0.001). Interestingly, improvement of sleep quality was not fully mediated by pain reduction. CONCLUSION: Our analysis underlines the relationship between pain and sleep in the clinical context. Improvement of sleep quality came along with pain reduction and vice versa. Further study should explain the exact mechanisms of action which are associated with the improvement of both symptom parameters.