Sleep Disturbance and Its Association with Pain Severity and Multisite Pain: A Prospective 10.7-Year Study

Overview

Journal Pain Ther

Date 2020 Oct 21

PMID 33085011

Citations 8

Authors

Feng Pan

Jing Tian

Flavia Cicuttini

Graeme Jones

Affiliations

Soon will be listed here.

Abstract

Introduction: Sleep disturbance is often comorbid with chronic pain disorders, with emerging evidence suggesting a stronger effect of sleep disturbance on pain than vice versa; however, few studies have evaluated the long-term associations between sleep disturbance and pain. This study was to examine the associations of sleep disturbance with knee pain severity, number of painful sites (NPS) and persistent pain in a 10.7-year cohort study.

Methods: A total of 1099 community-dwelling older adults (age mean ± SD, 63 ± 7.5 years; 51% female) were recruited and followed up at 2.6, 5.1 and 10.7 years later. Data on demographics, body mass index, physical activity and comorbidities were collected. At each time point, sleep disturbance, knee pain severity and NPS were assessed by using questionnaires. Multisite pain (MSP) was defined as NPS ≥ 2. Persistent knee pain or MSP was defined as having knee pain or MSP at all time points, respectively. Multivariable mixed-effects models and log-binomial regression were applied.

Results: In multivariable analyses, sleep disturbance was associated with greater knee pain severity (β 0.91/unit, 95% CI 0.70-1.11) and more NPS [(relative risk (RR) 1.10/unit, 95% CI 1.07-1.14] in a dose-response manner. Persistent sleep disturbance was associated with persistent knee pain (RR 1.90, 1.26-2.87) and MSP (RR 1.29, 1.07-1.56). Persistent knee pain and MSP were also associated with persistent sleep disturbance (knee pain: RR = 1.99; MSP: RR = 2.71, both P < 0.05).

Conclusions: Sleep disturbance was independently associated with greater pain severity and NPS in a dose-response manner. A reciprocal relationship between persistent sleep disturbance and persistent pain suggests treating either problem could help the other.

Citing Articles

Impact of Pain on Activities of Daily Living in Older Adults: A Cross-Sectional Analysis of Korean Longitudinal Study of Aging (KLoSA).

Singh A, Akkala S, Nayak M, Kotlo A, Poondla N, Raza S Geriatrics (Basel). 2024; 9(3.

PMID: 38804322 PMC: 11130898. DOI: 10.3390/geriatrics9030065.

Importance of sleep quality in functional abdominal pain disorder in pediatric patients.

Kim H Sleep Biol Rhythms. 2024; 20(1):81-85.

PMID: 38469067 PMC: 10897639. DOI: 10.1007/s41105-021-00342-9.

A common neuronal ensemble in nucleus accumbens regulates pain-like behaviour and sleep.

Sun H, Li Z, Qiu Z, Shen Y, Guo Q, Hu S Nat Commun. 2023; 14(1):4700.

PMID: 37543693 PMC: 10404280. DOI: 10.1038/s41467-023-40450-3.

Association between chronic pain and risk of incident dementia: findings from a prospective cohort.

Tian J, Jones G, Lin X, Zhou Y, King A, Vickers J BMC Med. 2023; 21(1):169.

PMID: 37143042 PMC: 10161483. DOI: 10.1186/s12916-023-02875-x.

Fall Risk in Elderly with Insomnia in Western Romania-A Retrospective Cross-Sectional Study.

Blajovan M, Arnautu D, Malita D, Tomescu M, Faur C, Arnautu S Medicina (Kaunas). 2023; 59(4).

PMID: 37109678 PMC: 10144438. DOI: 10.3390/medicina59040718.

References

Nicholl B, Mackay D, Cullen B, Martin D, Ul-Haq Z, Mair F . Chronic multisite pain in major depression and bipolar disorder: cross-sectional study of 149,611 participants in UK Biobank. BMC Psychiatry. 2014; 14:350. PMC: 4297369. DOI: 10.1186/s12888-014-0350-4. View

Frohnhofen H . Pain and sleep : A bidirectional relationship. Z Gerontol Geriatr. 2018; 51(8):871-874. DOI: 10.1007/s00391-018-01461-8. View

Ho K, Ferreira P, Pinheiro M, Aquino Silva D, Miller C, Grunstein R . Sleep interventions for osteoarthritis and spinal pain: a systematic review and meta-analysis of randomized controlled trials. Osteoarthritis Cartilage. 2018; 27(2):196-218. DOI: 10.1016/j.joca.2018.09.014. View

Mundal I, Grawe R, Bjorngaard J, Linaker O, Fors E . Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study. BMC Musculoskelet Disord. 2014; 15:213. PMC: 4089927. DOI: 10.1186/1471-2474-15-213. View

Christensen J, Johansen S, Knardahl S . Psychological predictors of change in the number of musculoskeletal pain sites among Norwegian employees: a prospective study. BMC Musculoskelet Disord. 2017; 18(1):140. PMC: 5379631. DOI: 10.1186/s12891-017-1503-7. View

Smith M, Haythornthwaite J . How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004; 8(2):119-32. DOI: 10.1016/S1087-0792(03)00044-3. View

Westoby C, Mallen C, Thomas E . Cognitive complaints in a general population of older adults: prevalence, association with pain and the influence of concurrent affective disorders. Eur J Pain. 2008; 13(9):970-6. DOI: 10.1016/j.ejpain.2008.11.011. View

Finan P, Goodin B, Smith M . The association of sleep and pain: an update and a path forward. J Pain. 2013; 14(12):1539-52. PMC: 4046588. DOI: 10.1016/j.jpain.2013.08.007. View

McBeth J, Lacey R, Wilkie R . Predictors of new-onset widespread pain in older adults: results from a population-based prospective cohort study in the UK. Arthritis Rheumatol. 2014; 66(3):757-67. PMC: 4163719. DOI: 10.1002/art.38284. View

10.

Carnes D, Parsons S, Ashby D, Breen A, Foster N, Pincus T . Chronic musculoskeletal pain rarely presents in a single body site: results from a UK population study. Rheumatology (Oxford). 2007; 46(7):1168-70. DOI: 10.1093/rheumatology/kem118. View

11.

Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M . The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014; 73(7):1323-30. DOI: 10.1136/annrheumdis-2013-204763. View

12.

Dore D, Winzenberg T, Ding C, Otahal P, Pelletier J, Martel-Pelletier J . The association between objectively measured physical activity and knee structural change using MRI. Ann Rheum Dis. 2012; 72(7):1170-5. DOI: 10.1136/annrheumdis-2012-201691. View

13.

Nicholls E, Thomas E, van der Windt D, Croft P, Peat G . Pain trajectory groups in persons with, or at high risk of, knee osteoarthritis: findings from the Knee Clinical Assessment Study and the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2014; 22(12):2041-50. PMC: 4256061. DOI: 10.1016/j.joca.2014.09.026. View

14.

Seaman S, White I . Review of inverse probability weighting for dealing with missing data. Stat Methods Med Res. 2011; 22(3):278-95. DOI: 10.1177/0962280210395740. View

15.

Hawthorne G, Richardson J, Osborne R . The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of health-related quality of life. Qual Life Res. 1999; 8(3):209-24. DOI: 10.1023/a:1008815005736. View

16.

Herrero Babiloni A, De Koninck B, Beetz G, De Beaumont L, Martel M, Lavigne G . Sleep and pain: recent insights, mechanisms, and future directions in the investigation of this relationship. J Neural Transm (Vienna). 2019; 127(4):647-660. DOI: 10.1007/s00702-019-02067-z. View

17.

Parthasarathy S, Vasquez M, Halonen M, Bootzin R, Quan S, Martinez F . Persistent insomnia is associated with mortality risk. Am J Med. 2014; 128(3):268-75.e2. PMC: 4340773. DOI: 10.1016/j.amjmed.2014.10.015. View

18.

Davies K, Macfarlane G, Nicholl B, Dickens C, Morriss R, Ray D . Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study. Rheumatology (Oxford). 2008; 47(12):1809-13. PMC: 2582170. DOI: 10.1093/rheumatology/ken389. View

19.

Fayaz A, Croft P, Langford R, Donaldson L, Jones G . Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open. 2016; 6(6):e010364. PMC: 4932255. DOI: 10.1136/bmjopen-2015-010364. View

20.

Pan F, Smith Byrne K, Ramakrishnan R, Ferreira M, Dwyer T, Jones G . Association between musculoskeletal pain at multiple sites and objectively measured physical activity and work capacity: Results from UK Biobank study. J Sci Med Sport. 2018; 22(4):444-449. DOI: 10.1016/j.jsams.2018.10.008. View