For at least some groups of young adults, sleep problems are a predictor of chronic pain and worsening pain severity over time, according to a study published in the journal Pain.
In contrast, the presence of pain generally doesn’t predict worsening sleep problems during the transition between adolescence and young adulthood, according to Irma J. Bonvanie, MD, University of Groningen, Groningen, the Netherlands, and colleagues.
The authors believe that early identification and treatment of sleep problems might help reduce later problems with pain in some groups of emerging adults.
For the study, the researchers analysed “bidirectional” relationships between sleep problems and pain in a follow-up study of young adults aged 19 to 22 years. The study focused on overall chronic pain as well as musculoskeletal, headache, and abdominal pain.
The long-term associations between sleep problems and the 3 pain types were compared between the sexes, and the mediating effects of anxiety and depression, fatigue, and physical activity were explored. The study included approximately 1,750 young Dutch men and women who were followed for 3 years.
About half of young people who had sleep problems at the initial evaluation still had them 3 years later. At baseline, subjects with sleep problems were more likely to have chronic pain and had more severe musculoskeletal, headache, and abdominal pain.
Three years later, those with sleep problems were more likely to have new or persistent chronic pain. Overall, 38% of emerging adults with severe sleep problems at initial evaluation had chronic pain at follow-up, compared with 14% of those without initial sleep problems.
The relationship between sleep problems and pain was stronger in women than men — a difference that may start around older adolescence/emerging adulthood. Fatigue appeared to be a modest mediating factor, while anxiety/depression and lack of physical activity were not significant contributors.
Sleep problems predicted increased severity of abdominal pain in women only but did not predict headache severity in either sex. Abdominal pain was the only type of pain associated with a long-term increase in sleep problems, and the effect was small.
“Our findings indicate the sleep problems are not only a precursor for pain, but actually predict the persistence of chronic pain and an increase in pain levels,” the authors wrote. The findings also suggest that “sleep problems may be an additional target for treatment and prevention strategies in female emerging adults with chronic pain and musculoskeletal pain.”
SOURCE: Wolters Kluwer Health