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Sleep problems and fatigue as predictors for the onset of chronic widespread pain over a 5- and 18-year perspective 11 Medical and Health Sciences 1117 Public Health and Health Services

Aili, Katarina ; Andersson, Maria LU ; Bremander, Ann LU ; Haglund, Emma LU ; Larsson, Ingrid and Bergman, Stefan LU (2018) In BMC Musculoskeletal Disorders 19(1).
Abstract

Background: Previous research suggests that sleep problems may be an important predictor for chronic widespread pain (CWP). With this study we investigated both sleep problems and fatigue as predictors for the onset of CWP over a 5-year and an 18-year perspective in a population free from CWP at baseline. Methods: To get a more stable classification of CWP, we used a wash-out period, including only individuals who had not reported CWP at baseline (1998) and three years prior baseline (1995). In all, data from 1249 individuals entered the analyses for the 5-year follow-up and 791 entered for the 18-year follow-up. Difficulties initiating sleep, maintaining sleep, early morning awakening, non-restorative sleep and fatigue were... (More)

Background: Previous research suggests that sleep problems may be an important predictor for chronic widespread pain (CWP). With this study we investigated both sleep problems and fatigue as predictors for the onset of CWP over a 5-year and an 18-year perspective in a population free from CWP at baseline. Methods: To get a more stable classification of CWP, we used a wash-out period, including only individuals who had not reported CWP at baseline (1998) and three years prior baseline (1995). In all, data from 1249 individuals entered the analyses for the 5-year follow-up and 791 entered for the 18-year follow-up. Difficulties initiating sleep, maintaining sleep, early morning awakening, non-restorative sleep and fatigue were investigated as predictors separately and simultaneously in binary logistic regression analyses. Results: The results showed that problems with initiating sleep, maintaining sleep, early awakening and non-restorative sleep predicted the onset of CWP over a 5-year (OR 1.85 to OR 2.27) and 18-year (OR 1.54 to OR 2.25) perspective irrespective of mental health (assessed by SF-36) at baseline. Also fatigue predicted the onset of CWP over the two-time perspectives (OR 3.70 and OR 2.36 respectively) when adjusting for mental health. Overall the effect of the sleep problems and fatigue on new onset CWP (over a 5-year perspective) was somewhat attenuated when adjusting for pain at baseline but remained significant for problems with early awakening, non-restorative sleep and fatigue. Problems with maintaining sleep predicted CWP 18 years later irrespective of mental health and number of pain regions (OR 1.72). Reporting simultaneous problems with all four aspects of sleep was associated with the onset of CWP over a five-year and 18-yearperspective, irrespective of age, gender, socio economy, mental health and pain at baseline. Sleep problems and fatigue predicted the onset of CWP five years later irrespective of each other. Conclusion: Sleep problems and fatigue were both important predictors for the onset of CWP over a five-year perspective. Sleep problems was a stronger predictor in a longer time-perspective. The results highlight the importance of the assessment of sleep quality and fatigue in the clinic.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
CWP, Insomnia, Longitudinal study, Musculoskeletal pain, Population study, Prospective study
in
BMC Musculoskeletal Disorders
volume
19
issue
1
article number
390
publisher
BioMed Central (BMC)
external identifiers
  • pmid:30390670
  • scopus:85056127843
ISSN
1471-2474
DOI
10.1186/s12891-018-2310-5
language
English
LU publication?
yes
id
8a448bee-bc99-44bc-bb8c-2906bc5ab5da
date added to LUP
2018-11-22 12:00:12
date last changed
2020-08-12 08:19:49
@article{8a448bee-bc99-44bc-bb8c-2906bc5ab5da,
  abstract     = {<p>Background: Previous research suggests that sleep problems may be an important predictor for chronic widespread pain (CWP). With this study we investigated both sleep problems and fatigue as predictors for the onset of CWP over a 5-year and an 18-year perspective in a population free from CWP at baseline. Methods: To get a more stable classification of CWP, we used a wash-out period, including only individuals who had not reported CWP at baseline (1998) and three years prior baseline (1995). In all, data from 1249 individuals entered the analyses for the 5-year follow-up and 791 entered for the 18-year follow-up. Difficulties initiating sleep, maintaining sleep, early morning awakening, non-restorative sleep and fatigue were investigated as predictors separately and simultaneously in binary logistic regression analyses. Results: The results showed that problems with initiating sleep, maintaining sleep, early awakening and non-restorative sleep predicted the onset of CWP over a 5-year (OR 1.85 to OR 2.27) and 18-year (OR 1.54 to OR 2.25) perspective irrespective of mental health (assessed by SF-36) at baseline. Also fatigue predicted the onset of CWP over the two-time perspectives (OR 3.70 and OR 2.36 respectively) when adjusting for mental health. Overall the effect of the sleep problems and fatigue on new onset CWP (over a 5-year perspective) was somewhat attenuated when adjusting for pain at baseline but remained significant for problems with early awakening, non-restorative sleep and fatigue. Problems with maintaining sleep predicted CWP 18 years later irrespective of mental health and number of pain regions (OR 1.72). Reporting simultaneous problems with all four aspects of sleep was associated with the onset of CWP over a five-year and 18-yearperspective, irrespective of age, gender, socio economy, mental health and pain at baseline. Sleep problems and fatigue predicted the onset of CWP five years later irrespective of each other. Conclusion: Sleep problems and fatigue were both important predictors for the onset of CWP over a five-year perspective. Sleep problems was a stronger predictor in a longer time-perspective. The results highlight the importance of the assessment of sleep quality and fatigue in the clinic.</p>},
  author       = {Aili, Katarina and Andersson, Maria and Bremander, Ann and Haglund, Emma and Larsson, Ingrid and Bergman, Stefan},
  issn         = {1471-2474},
  language     = {eng},
  month        = {11},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Musculoskeletal Disorders},
  title        = {Sleep problems and fatigue as predictors for the onset of chronic widespread pain over a 5- and 18-year perspective 11 Medical and Health Sciences 1117 Public Health and Health Services},
  url          = {http://dx.doi.org/10.1186/s12891-018-2310-5},
  doi          = {10.1186/s12891-018-2310-5},
  volume       = {19},
  year         = {2018},
}