Background/Purpose: 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 effect of sleep disturbance on pain. This study sought to examine the association of sleep disturbance with knee pain severity and number of painful sites (NPS) and investigate whether persistent sleep disturbance increases the risk of persistent pain.

Methods: 1,099 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-year later. Data on demographics, body mass index, physical activity, comorbidities were collected. At each time-point, sleep disturbance, knee pain severity and NPS were assessed by using questionnaires. Radiographic knee osteoarthritis (ROA) was measured using x-ray. Multi-site pain (MSP) was defined as NPS ≥2. Persistent pain was defined as having knee pain or MSP at all time-points. Multivariable mixed-effects models and log-binomial regression were applied for the analyses.

Results: Sleep disturbance was associated with greater knee pain severity (β 0.91, 95%CI 0.70-1.11) and higher risk of having more NPS [(Relative risk (RR) 1.10, 95%CI 1.07-1.14] in a dose-response manner in multivariable analyse with adjustment for age, sex, body mass index, physical activity, comorbidities, pain medications, ever smoking, emotional problems, employment, and education level. Persistent sleep disturbance was associated with a greater risk of persistent knee pain (RR 1.90, 1.26-2.87) and MSP (RR 1.29, 1.07-1.56). In participants with ROA, results were similar apart from the link between sleep disturbance and persistent pain.

pain.

Conclusion: Sleep disturbance was independently associated with greater pain severity and significantly increases risk for MSP with a long-term effect of sleep on pain in general and ROA population, suggesting beneficial effects of treating sleep problems on long-term pain control.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/sleep-disturbance-and-pain-severity-and-multi-site-pain-a-prospective-10-7-year-follow-up-study/