Tang, Nicole K. Y., McBeth, John, Jordan, Kelvin, Blagojevic-Bucknall, Milisa, Croft, Peter and Wilkie, Ross (2015) Impact of musculoskeletal pain on insomnia onset : a prospective cohort study. Rheumatology, Volume 54 (Number 2). pp. 248-256. doi:10.1093/rheumatology/keu283 ISSN 1462-0324.

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Abstract

Objective. Pain, the most common manifestation of rheumatological conditions, is highly prevalent among older adults, with worse health outcomes found in those with co-morbid insomnia. Proactive prevention of insomnia may reduce the overall disease burden of pain and rheumatological conditions. To inform such development, this study examined the role of pain, physical limitation and reduced social participation in predicting and mediating insomnia onset.

Methods. A prospective cohort study was conducted involving 6676 individuals ≥50 years of age who completed questionnaires at baseline and a 3-year follow-up. Participants were classified into none, some and widespread pain according to the ACR criteria. Logistic regression was used to examine the relationship between baseline pain and insomnia onset at 3 years. Path analysis was used to test for the mediating role of physical limitation and social participation restriction.

Results. Some [adjusted odds ratio (AOR) 1.57 (95% CI 1.15, 2.13)] and widespread [2.13 (1.66, 3.20)] pain increased the risk of insomnia onset at 3 years, after adjusting for age, gender, socio-economic class, education, anxiety, depression, sleep and co-morbidity at baseline. The combination of physical limitation and reduced social participation explained up to 68% of the effect of some pain on insomnia onset and 66% of the effect of widespread pain on insomnia onset.

Conclusions. There was a dose–response association between the extent of pain at baseline and insomnia onset at 3 years that was substantially mediated by physical limitation and reduced social participation. Targeting physical limitation and social participation in older people with pain may buffer co-morbid insomnia, reducing the overall disease burden.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Science > Psychology
Library of Congress Subject Headings (LCSH):	Musculoskeletal system -- Diseases, Insomniacs, Older people -- Diseases, Pain -- Treatment
Journal or Publication Title:	Rheumatology
Publisher:	Oxford University Press
ISSN:	1462-0324
Official Date:	February 2015
Dates:	Date Event February 2015 Published 14 August 2014 Available 24 May 2014 Accepted 1 November 2013 Submitted
Volume:	Volume 54
Number:	Number 2
Page Range:	pp. 248-256
DOI:	10.1093/rheumatology/keu283
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	27 December 2015
Date of first compliant Open Access:	27 December 2015
Funder:	Medical Research Council (Great Britain) (MRC), North Staffordshire Research and Development Consortium (NSRDC)
Grant number:	G9900220 (MRC),

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