Summary

Sleep position can affect shoulder pain. This study correlated the relationship between sleep position and shoulder pain.

Abstract

Introduction

Shoulder pain while sleeping is well accepted as a common complaint in patients with shoulder pathology. However, due to the high prevalence of shoulder pain in the general population, the theory of use does not provide an adequate explanation for those who do not participate in activities that involve repetitive use of the shoulder. We propose a more generally applicable mechanism through sleep; the shoulder subluxes superiorly to allow impingement of the rotator cuff tendon against the acromion. Materials and Methods: A 24-question survey on sleep position and shoulder pain (measured by the American Shoulder and Elbow Surgeons (ASES) Society shoulder assessment) was distributed to 8,996 adults through email to yield 516 participants, 485 of which reported having shoulder pain. Those who reported previously sleeping in the lateral decubitus position, on average reported later experiencing the greatest shoulder pain. Reported current sleep positions suggest that participants who experienced shoulder pain since altered their behavior to sleep on the alternate pain-free shoulder or to sleep in the supine position. Results: Looking towards laterality of sleep side and shoulder pain, reported sleep side before experiencing shoulder pain significantly correlated with shoulder pain laterality (p = 1.38e-11), suggesting that sleeping in the lateral decubitus position may lead to shoulder pain. Additionally, after excluding those who reported performing repetitive actions that involve their shoulder, such as in sports or work, hand dominance no longer appeared to contribute to shoulder pain laterality (p = 0.524). Conclusion: This study suggests a reasonable etiology for common rotator cuff pathologies and a manageable method to prevent shoulder pain.