Uyku Postürü ile Subakromiyal Sıkışma Sendromu Arasındaki İlişki

Abstract

The most common cause of shoulder pain is subacromial impingement syndrome (SAIS). One of the possible etiological factors of SAIS is sleep posture. The number of studies revealing the relationship between sleep posture and SAIS is limited and mainly includes outcomes obtained from subjective data. This study, it is aimed to evaluate the relationship between SAIS and sleep posture objectively. For this purpose, after the approval of the ethics committee, patients who had polysomnography (PSG) at Hacettepe University Ear, Nose, Throat (ENT) Department Sleep Laboratory between February 2021 and June 2021 were examined after obtaining informed consent and were subjected to a questionnaire seeking demographic information and possible etiological factors. Inclusion criteria for the study; male gender and being in the 40-70 age range. The exclusion criteria are; working in a job that may cause SAIS, such as occupations that require repetitive shoulder movement, are exposed to vibration, or lift heavy loads; professionally or recreationally playing a sport such as tennis, swimming, javelin throwing, which has also a place in the etiology of SAIS; have previously received treatment for shoulder pain; having a history of trauma involving the aching shoulder; bilateral shoulder pain; having an additional disease that will affect sleep posture and movements during sleep (history of stroke, neurological disease, etc.); having a condition that can cause shoulder pain (cervical disc herniation, peripheral neuropathy, intrathoracic pathologies, rheumatological diseases, etc.) and patients who met only one of the two SAIS diagnosis criteria. During this period, 71 patients who met the inclusion criteria out of 149 patients who underwent PSG were included in the study. Shoulder pain persisting for at least one month; and having at least three positives of following; painful arc test, Neer impingement test, Hawkins-Kennedy test and Empty Can test were included in the SAIS group (34 patients), and the remaining patients were included in the control group (37 patients). Demographic data of the patients, the time they spent in different postures during sleep (supine, lateral decubitus, and prone), and sleep quality data (sleep efficiency, sleep duration) were recorded. While it was determined that significantly more of the patients in the SAIS group were smokers (p:0.006), no significant difference was found between the two groups in terms of other demographic data. It was seen that the time spent by the SAIS group in the lateral decubitus (LD) position was significantly higher than the control group (p:0.003), and the patients in the SAIS group spent significantly more of their sleep time in the LD position on the aching shoulder (p<0.001). In addition, it was observed that the number of position changes during sleep was significantly higher in the control group (p:0.002). There was no significant difference between the two groups regarding sleep time and sleep efficiency (p: 0.679, p: 0.982). This study objectively demonstrated the relationship between sleep posture and SAIS using sleep posture data obtained during PSG. With this feature, it differs from the limited number of studies that have been done on this subject before. Because in these studies, the sleep postures of the patients were recorded by the statements of the patients. With this study, it has been shown that the LD position is a risk factor for SAIS occurrence, and the high frequency of posture changes during sleep may also be a protective factor for SAIS.