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Pain and severe sleep disturbance in the general population: Primary data and meta-analysis from 240,820 people across 45 low- and middle-income countries

updated

Tags: etiology, sleep, chronic pain, pro, pain problems

Two articles on PainSci cite Stubbs 2018: (1) 6 Main Causes of Morning Back Pain(2) Insomnia Until it Hurts

PainSci notes on Stubbs 2018:

This 2018 study went looked at links between pain and severe sleep problems around the world, finding that “pain and sleep problems are highly co-morbid,” echoing what many other studies have found, but specifically confirming the link in diverse populations. They extracted their findings from data on almost a quarter million people in low- and middle-income countries. In other words, there is a strong link between poor sleep and health that is definitely not just a case of the “worried well” sweating the little stuff in their relatively cushy lives. The sleep-health link matters no matter where you’re from.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: Pain and sleep disturbances are widespread, and are an important cause of a reduced quality of life. Despite this, there is a paucity of multinational population data assessing the association between pain and sleep problems, particularly among low- and middle-income countries (LMICs). Therefore, we investigated the relationship between pain and severe sleep disturbance across 45 LMICs.

METHOD: Community-based data on 240,820 people recruited via the World Health Survey were analyzed. Multivariable logistic regression analyses adjusted for multiple confounders were performed to quantify the association between pain and severe sleep problems in the last 30  days. A mediation analysis was conducted to explore potential mediators of the relationship between pain and severe sleep disturbance.

RESULTS: The prevalence of mild, moderate, severe, and extreme levels of pain was 26.0%, 16.2%, 9.1%, and 2.2% respectively, whilst 7.8% of adults had severe sleep problems. Compared to those with no pain, the odds ratio (OR, 95% CI) for severe sleep problems was 3.65 (3.24-4.11), 9.35 (8.19-10.67) and 16.84 (13.91-20.39) for those with moderate, severe and extreme pain levels respectively. A country wide meta-analysis adjusted for age and sex demonstrated a significant increased OR across all 45 countries. Anxiety, depression and stress sensitivity explained 12.9%, 3.6%, and 5.2%, respectively, of the relationship between pain and severe sleep disturbances.

CONCLUSION: Pain and sleep problems are highly co-morbid across LMICs. Future research is required to better understand this relationship. Moreover, future interventions are required to prevent and manage the pain and sleep disturbance comorbidity.

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