Sleep Disorders Predict Pain in Young Adults

New research suggests that sleep problems may be a target for treatment of "emerging adults" with musculoskeletal pain complaints. Sleep issues in this patient group predicted chronic pain and worsening pain severity over time.

Dutch research indicates that sleep problems may be a target for treatment of female “emerging adults” with musculoskeletal pain complaints. Published in the April 2016 issue of Pain, the study found that sleep issues in this patient group predicted chronic pain and worsening pain severity over time.

The relationship appears to be a one-way street, as the presence of pain does not predict worsening sleep problems during the transition between adolescents and young adulthood, according to Irma J. Bonvanie, MD, Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands, and colleagues. The team suggests that early identification and treatment of sleep problems may help reduce later pain in some individuals making the transition from childhood to adulthood.

The study team conducted the study based on the widely held belief that sleep and pain are related to one another on a daily basis in adolescents with chronic pain complaints, as well as study results showing that sleep issues predict the long-term onset of musculoskeletal pain in middle-aged adults. The long-term effects of sleep issues on pain duration and various types of pain severity in emerging adults (those aged 18 to 25 years) remained unclear.

For the study, Bonvanie and colleagues investigated the cross-sectional and longitudinal relationship between sleep problems and chronic pain, musculoskeletal pain, headache, and abdominal pain severity in a general population of about 1,750 Dutch men and women aged 19 to 22 who were followed for 3 years.

The team assessed whether these relationships were moderated by gender and whether symptoms of anxiety or depression, fatigue, or physical inactivity mediated these effects.

Nearly 50% of participants who had sleep issues during baseline evaluations continued to suffer from them at 3 years. At 3 years follow-up, sleep issues were associated with chronic pain, musculoskeletal pain, and headache and abdominal pain severity. Sleep issues at 3 years also predicted chronic pain and an increase in musculoskeletal pain.

Overall, 38% of emerging adults with severe sleep problems at baseline had chronic pain at follow-up, compared with a rate of 14% observed in those without sleep issues at baseline.

This relationship between sleep problems and pain was stronger in females than in males and was modestly mediated by fatigue but not by symptoms of anxiety and depression or physical inactivity. Abdominal pain severity was predicted by sleep problems only in women, but sleep problems did not predicted headache severity in either gender. Abdominal pain was the only pain type 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,” Write the researchers. “Our findings suggest that sleep problems may be an additional target for treatment and prevention strategies in female emerging adults with chronic pain and musculoskeletal pain.”