Background/Purpose: The primary symptom of arthritis is chronic pain which has widespread consequences on an individual’s sleep and mental health. Research suggests that sleep and chronic pain may synergistically impact depression. However, to date no study has examine the joint effect that sleep and chronic pain may have on the development of depressive symptoms.

Methods: Data for this study was utilized from the 2010-2016 waves of Health and Retirement Survey (HRS). The study included data from 6,933 individuals with arthritis and were free of depressive symptoms at the baseline (2010). We performed a multivariable-adjusted Cox proportional hazards regression to estimate the hazard ratio for the joint effect of pain and sleep problem relative to having neither conditions on the development of depressive symptoms (CES-D>3). Sex, gender, race, smoking status, comorbidity count, physical activity limitation, and BMI were all considered for our modeling procedures. We calculated the relative excess risk due to interaction, comparing the joint effect with that of pain alone and sleep problem alone. Analysis was further stratified by sex.

Results: There was evidence of a synergistic effect of pain and sleep on risk of depressive symptoms adjusted-HR (95% CI):2.87(2.80,4.99) and RERI of 0.38. When stratified by sex, a similar synergistic effect was observed in men with adjusted-HR(95% CI):3.30(2.16,5.05) and RERI of 1.43.

Conclusion: Findings from this study suggest that sleep and pain are synergistically linked to the development of depressive symptoms. Understanding the joint effect of pain and sleep on individuals’ increased risk of depressive symptoms can help target treatment options for arthritis patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-association-of-pain-and-sleep-in-relation-to-depressive-symptoms-among-older-adults-with-arthritis/