Purpose: Using data from an epidemiological study described elsewhere (Gordon et al 2002 & 2007), multivariate logistic regression models were constructed to explore the association between sleep position, factors related to sleep quality, and the prevalence of waking symptoms (cervical spine pain and stiffness, headache, and aching in scapulae or arm regions). Method: A causal model was developed in which putative exposures were tested for their association with sleep quality, which was considered as an antecedent cause of waking cervico-thoracic symptoms. Results: Factors which significantly constrained sleep quality were identified as the presence of a medical condition, past history of injury or accident to the cervical spine, sleep position, and nocturnal bruxism. Poor sleep quality was significantly related to waking cervico-thoracic symptoms. Conclusions: The significant relationships between these factors highlight the need for assessment of all possible causes of waking cervico-thoracic symptoms in the clinical setting.




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