Sleep problems, exercise and obesity and risk of chronic musculoskeletal pain: The Norwegian HUNT study

1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
The European Journal of Public Health (Impact Factor: 2.59). 11/2013; DOI: 10.1093/eurpub/ckt198
Source: PubMed


The objective was to investigate the association between self-reported sleep problems and risk of chronic pain in the low back and neck/shoulders, and whether physical exercise and body mass index (BMI) alter this association.
The study comprised data on 26 896 women and men in the Nord-Trøndelag Health Study (Norway) without chronic pain or physical impairment at baseline in 1984-86. Occurrence of chronic pain was assessed at follow-up in 1995-97. A generalized linear model was used to calculate adjusted risk ratios.
Sleep problems were dose-dependently associated with risk of pain in the low back and neck/shoulders in both women and men (P < 0.001 both genders). Women and men who reported sleep problems 'sometimes' and 'often/always' had a higher risk of chronic pain of 23-32% and 51-66%, respectively, than those who reported sleep problems 'never'. Combined analyses showed that persons with sleep problems 'sometimes' and who exercised ≥1 hour per week had lower risk of chronic pain in the low back (P < 0.04) and neck/shoulders (P < 0.001) than inactive persons with a similar level of sleep problems (P < 0.04). Likewise, persons with BMI <25 kg/cm(2) and sleep problems 'sometimes' had lower risk of chronic pain in the low back (P < 0.001) and neck/shoulders (P < 0.001) than persons with BMI ≥25 kg/cm(2) and a similar level of sleep problems.
Sleep problems are associated with an increased risk of chronic pain in the low back and neck/shoulders. Regular exercise and maintenance of normal body weight may reduce the adverse effect of mild sleep problems on risk of chronic pain.

Download full-text


Available from: Paul Jarle Mork, Dec 14, 2013
    • "Moreover,athletespracticingcontactsportswhoexperienced concussionsduringthepreviousyearreportedmoresymptomsof sleepdisturbanceandpoorersleepqualitythandidthecontrols [125]andsubjectswithalowsleepquantitythenightbeforethe concussionreportedbothagreaternumbergreaternumberof symptomsandmoreseveresymptomsaftertheconcussion[126]. Sleeprestrictionisapotentcontributortothedevelopmentofsomaticsymptoms ,particularlyinmalesassociatingbothsleep deprivationandexercise[10]whoreportedincreasedpainsensi- tivity[127].Inparticular,sleepproblemsareassociatedwithan increasedriskofchronicpaininthelowerback,neckandshoulders [13].Nevertheless,regularexerciseandmaintenanceofnormal bodyweightmayreducetheadverseeffectsofmildsleepproblems ontheriskofchronicpain[13].Takentogether,theseresultssug- gestthecreationofaperniciouscircleincludingsleeploss,injuries, decreasedrecoverypatterns,anincreasedpainthatthemselves favorsleepdisturbances. Sleepdisturbancesarealsoassociatedwithovertrainingduring periodsofhighvolumetraining[94] [128] [129].Moreoverreduced sleepqualitycanbeassociatedwithhigherprevalenceofupper respiratorytractinfectionsinoverreachingpopulations[130]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Sleep and exercise influence each other through complex, bilateral interactions that involve multiple physiological and psychological pathways. Physical activity is usually considered as beneficial in aiding sleep although this link may be subject to multiple moderating factors such as sex, age, fitness level, sleep quality and the characteristics of the exercise (intensity, duration, time of day, environment). It is therefore vital to improve knowledge in fundamental physiology in order to understand the benefits of exercise on the quantity and quality of sleep in healthy subjects and patients. Conversely, sleep disturbances could also impair a person’s cognitive performance or their capacity for exercise and increase the risk of exercise-induced injuries either during extreme and/or prolonged exercise or during team sports. This review aims to describe the reciprocal fundamental physiological effects linking sleep and exercise in order to improve the pertinent use of exercise in sleep medicine and prevent sleep disorders in sportsmen.
    Sleep Medicine Reviews 06/2014; 20. DOI:10.1016/j.smrv.2014.06.008 · 8.51 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Low back pain is a critical public health problem; this condition significantly affects the quality of life and has a major socioeconomic impact. The present study aimed to investigate the interference of low back pain with everyday functions of life in disability care workers, and to examine the influencing factors of the interference, such as workers’ demographic, lifestyle habits, self-reported health status, working conditions and previous pain experience. The Wong-Baker FACES Pain Rating Scale and Brief Pain Inventory – Short Form were used to identify the pain severity and life interference of 677 participants who had experienced low back pain conditions in the previous year. The results indicated that the mean score of the pain severity was 3.78 ± 1.82, 78.9% subjects experienced mild pain (score 2–4), 13.7% subjects experienced moderate pain, and 5.3% subjects experienced severe pain. More than twenty percent of the respondents reported that low back pain moderately or severely interfered with their daily functions. Many working conditions and pain experienced significantly correlated with the score of pain interference in the care workers after controlling for factors of healthy lifestyle and health status (R2 = 41.7%). These findings may garner attention from health welfare authorities and lead to improvements in health promotion initiatives to prevent low back pain from interfering with the daily activities of care workers for people with intellectual, autistic and associated disabilities.
    Research in Autism Spectrum Disorders 06/2014; 8(6):692–700. DOI:10.1016/j.rasd.2014.03.011 · 2.96 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic pain has a significant negative impact on the quality of life, including sleep disruption. There is compelling evidence that cognitive-behavioral therapy can be effective in treating sleep disorders. To our knowledge, no research has been carried out on brief cognitive-behavioral educational interventions in individuals with chronic pain. This study was conducted to determine whether a brief education session that incorporates sleep hygiene and cognitive-behavioral strategies would help improve the sleep of individuals with chronic pain. Eighty-five patients from a tertiary care Multidisciplinary Pain Centre completed all aspects of the study. This sample was randomized into 2 groups: a treatment group who received a brief cognitive-behavioral educational session, and a control group who did not. All participants completed a daily sleep diary for 28 days. Measures on sleep quality, beliefs and attitudes about sleep, pain, disability, and mood were recorded at baseline. No significant differences were found between groups on demographic, pain, disability, mood measures, or sleep quality at baseline. Overall, 42% of the individuals who completed this study had depression scores above the clinical cutoff. This sample reported a high level of pain-related disability. Individuals in the treatment group had significantly reduced sleep onset latency compared to controls. No significant differences between groups on the number of times waking or hours slept. Our findings suggest that there is potential for a brief educational intervention to have a positive impact on some aspects of sleep in the chronic pain population. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Rehabilitation Psychology 05/2015; 60(2):193-200. DOI:10.1037/rep0000035 · 1.91 Impact Factor
Show more