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Lindholm, A., Roswall, J., Alm, B., Almquist-Tangen, G., Bremander, A., Dahlgren, J., . . . Bergman, S. (2019). Body mass index classification misses to identify children with an elevated waist-to-height ratio at 5 years of age. Pediatric Research, 85(1), 30-32
Open this publication in new window or tab >>Body mass index classification misses to identify children with an elevated waist-to-height ratio at 5 years of age
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2019 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 85, no 1, p. 30-32Article in journal (Refereed) Published
Abstract [en]

Background:  Abdominal adiposity is an important risk factor in the metabolic syndrome. Since BMI does not reveal fat distribution, waist-to-height ratio (WHtR) has been suggested as a better measure of abdominal adiposity in children, but only a few studies cover the preschool population. The aim of the present study was to examine BMI and WHtR growth patterns and their association regarding their ability to identify children with an elevated WHtR at 5 years of age.

Methods: A population-based longitudinal birth cohort study of 1540 children, followed from 0 to 5 years with nine measurement points. The children were classified as having WHtR standard deviation scores (WHtRSDS) <1 or ≥1 at 5 years. Student’s t-tests and Chi-squared tests were used in the analyses.

Results: Association between BMISDS and WHtRSDS at 5 years showed that 55% of children with WHtRSDS ≥1 at 5 years had normal BMISDS (p < 0.001). Children with WHtRSDS ≥1 at 5 years had from an early age significantly higher mean BMISDS and WHtRSDS than children with values <1.

Conclusions: BMI classification misses every second child with WHtRSDS ≥1 at 5 years, suggesting that WHtR adds value in identifying children with abdominal adiposity who may need further investigation regarding cardiometabolic risk factors.

© 2018, International Pediatric Research Foundation, Inc.

Place, publisher, year, edition, pages
New York, NY: Nature Publishing Group, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:hh:diva-38474 (URN)10.1038/s41390-018-0188-4 (DOI)30287892 (PubMedID)2-s2.0-85054473136 (Scopus ID)
Projects
Halland Health and Growth Study
Available from: 2018-12-03 Created: 2018-12-03 Last updated: 2019-01-29Bibliographically approved
Arvidsson, S., Nylander, M. & Bergman, S. (2019). Callers´perceptions of their contact with a rheumatology telephone helpline. Musculoskeletal Care, 17(1), 105-112
Open this publication in new window or tab >>Callers´perceptions of their contact with a rheumatology telephone helpline
2019 (English)In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 17, no 1, p. 105-112Article in journal (Refereed) Published
Abstract [en]

Background: Telephone helplines are useful for improving patients' access to healthcare services and reducing the need for frequent face‐to‐face contact with healthcare professionals. Little is known about how people who phone a helpline perceive the encounter.

Objectives: The aims of the present study were to describe the variation in how callers perceive their encounter with a rheumatology telephone helpline.

Methods: The  study  had  a  descriptive,  qualitative  design  and  used  a phenomenographic approach, comprising 27 semi‐structured telephone interviews with callers to Rheuma Direct, a rheumatology telephone helpline with specially trained nurses. The callers comprised 22 women and five men, aged 22–89 years (mean 54 years).

Results: The callers phoned Rheuma Direct when they had problems obtaining answers to questions on the internet or from healthcare professionals. Three descriptive categories emerged: constructive dialogue, specialized competence and applicability. The callers perceived that it was a constructive dialogue when they were able to discuss their concerns with someone, received emotional support, felt reassured and were satisfied with the information provided. They perceived specialized competence when the nurses were experienced and skilful, the advice provided complemented previously received information and when they had more knowledge after the call. The callers perceived that Rheuma Direct had applicability because it was easy to access and they could make different choices before, during and after the telephone call. 

Conclusions: Callers to a rheumatology telephone helpline perceived it as a valuable complement to other sources of information, and felt that it could provide them with the tools to manage their disease better, as well as future contacts with healthcare professionals. © 2018 The Authors Musculoskeletal Care published by John Wiley & Sons Ltd.

Place, publisher, year, edition, pages
Oxford: John Wiley & Sons, 2019
Keywords
nurse, qualitative research, rheumatology
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-38460 (URN)10.1002/msc.1374 (DOI)30468564 (PubMedID)2-s2.0-85057111450 (Scopus ID)
Note

Funding: Swedish Rheumatism Association (grant number: R‐558491) & Spenshult Research and Development Centre

Available from: 2018-11-30 Created: 2018-11-30 Last updated: 2019-03-29Bibliographically approved
Lindholm, A., Bergman, S., Alm, B., Almquist-Tangen, G., Dahlgren, J. & Roswall, J. (2019). Infant body mass index growth patterns predicted overweight at five years, waist-to-height ratio did not add to this predictivity. Acta Paediatrica, 108(5), 945-953
Open this publication in new window or tab >>Infant body mass index growth patterns predicted overweight at five years, waist-to-height ratio did not add to this predictivity
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 5, p. 945-953Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of the present study was to examine body mass index (BMI) and waist‐to‐height ratio (WHtR) growth patterns from birth until five years regarding their ability to predict overweight or obesity in children at five years of age.

Methods: Population‐based longitudinal birth cohort study of 1540 children from the south‐west region of Sweden, recruited at the first visit to the child health care centres in 2007–2008. The children were followed for five years and classified into two weight groups according to the 2012 International Obesity Task Force criteria. BMI and WHtR standard deviation scores (SDS) were analysed with Student's t‐tests and multiple logistic regression models. ©2018 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd

Results: BMI‐SDS and WHtR‐SDS growth patterns were from an early age different in children with overweight or obesity, compared to in children with normal weight or underweight. Overweight or obesity was significantly predicted by BMI‐SDS at 0–1 month (p < 0.001), ΔBMI‐SDS between 0–1 and 12 months (p < 0.001) and between 18 and 48 months (p < 0.001), but not by WHtR‐SDS, except for a negative association between 18 and 48 months in the boys (p = 0.040).

Conclusion: Overweight or obesity at five years could be predicted by early BMI‐SDS growth patterns, and WHtR‐SDS did not add to the predictivity with regard to BMI‐SDS. ©2018 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell Publishing Inc., 2019
Keywords
Body mass index, Childhood obesity, Childhood overweight, Growth patterns, Waist-to-height ratio
National Category
Pediatrics
Identifiers
urn:nbn:se:hh:diva-38475 (URN)10.1111/apa.14572 (DOI)30192410 (PubMedID)2-s2.0-85055058956 (Scopus ID)
Note

Funding: Region Halland, Research and Development Center Spenshult, Her Royal Highness Crown Princess Lovisa's Association for Child Care/Axel Tielmans Memorial Fund and Halmstad University.

Available from: 2018-12-03 Created: 2018-12-03 Last updated: 2019-04-12Bibliographically approved
Bergman, S., Haglund, E., Aili, K., Olsson, C. & Bremander, A. (2018). Chronic widespread pain, sleep problems and pressure pain thresholds in a population sample. Paper presented at EULAR, Annual European Congress of Rheumatology, 13-16 June, 2018 Amsterdam, Netherlands. Annals of the Rheumatic Diseases, 7(2), 1645-1646
Open this publication in new window or tab >>Chronic widespread pain, sleep problems and pressure pain thresholds in a population sample
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 7, no 2, p. 1645-1646Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2018
National Category
Physiotherapy
Identifiers
urn:nbn:se:hh:diva-38548 (URN)10.1136/annrheumdis-2018-eular.6827 (DOI)000444351005059 ()
Conference
EULAR, Annual European Congress of Rheumatology, 13-16 June, 2018 Amsterdam, Netherlands
Available from: 2018-12-13 Created: 2018-12-13 Last updated: 2018-12-13Bibliographically approved
Malm, K., Bergman, S., Bremander, A., Larsson, I. & Andersson, M. L. (2018). Discussions of lifestyle habits as an integral part of care management in patients with established rheumatoid arthritis. Paper presented at Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018. Annals of the Rheumatic Diseases, 77, 1817-1817, Article ID FRI10741-HPR.
Open this publication in new window or tab >>Discussions of lifestyle habits as an integral part of care management in patients with established rheumatoid arthritis
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, p. 1817-1817, article id FRI10741-HPRArticle in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Rheumatoid arthritis (RA) is associated with an increased risk of developing comorbidities which are known to be associated with lifestyle-related habits; such as having a sedentary lifestyle, having an unhealthy diet, smoking, and over-consumption of alcohol. In 2010, the European League Against Rheumatism (EULAR) published general guidelines on risk management in patients with RA, with an update 2017 (1,2) in which health professionals are encouraged to prioritize discussions with patients regarding their lifestyle and it is of interest to study the extent to which these discussions actually occur.

Objectives: To study if lifestyle habits; physical activity, diet, smoking and alcohol had been discussed with patients having RA during health care visits.

Methods: A cross-sectional postal survey in 2017 included 1542 eligible patients from the BARFOT (Better Anti-Rheumatic Pharmacotherapy) study. All patients received a questionnaire including lifestyle habits (physical activity, diet, smoking, and alcohol), and whether these habits had been discussed during health care visits. There was also a question regarding if they would have wanted such a discussion.

Results: 1,061 patients (68%) responded to the survey (mean age 67 years (SD 13); 73% women). Physical activity was discussed with 49% of the patients (figure 1A). Those who reported that they were active on a health-enhancing level were more likely to have discussed physical activity with health professionals. Diet had been discussed with 23% of the patients (figure 1B). Patients who reported a non-traditional mixed diet were more likely to have discussed diet. Smoking was discussed with 25% of the patients (figure 1C). Current smokers had more often discussed smoking habits with healthcare professionals compared with never smokers (32% vs. 17%; p=0.000). Alcohol had been discussed with 17% of the patients (figure 1D). Of the patients with hazardous drinking habits, 77% had not had a discussion regarding alcohol.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2018
Keywords
lifestyle habits, rheumatoid arthritis
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-37137 (URN)
Conference
Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018
Note

On behalf of The BARFOT study group

Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-07-27Bibliographically approved
Bremander, A., Haglund, E. & Bergman, S. (2018). Measures of Physical Activity and Fear Avoidance in People with Chronic Pain. Paper presented at Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018. Annals of the Rheumatic Diseases, 77(Suppl. 2), 1829-1830, Article ID SAT0737-HPR.
Open this publication in new window or tab >>Measures of Physical Activity and Fear Avoidance in People with Chronic Pain
2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, no Suppl. 2, p. 1829-1830, article id SAT0737-HPRArticle in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background Lifestyle factors such as physical activity (PA) has the possibility to contribute to improved health and quality of life in the population as well as in chronic diseases. Most often PA is self-reported while measures of the aerobic capacity are more seldom measured in subjects with chronic pain.

Objectives To describe physical activity levels (self-reported and aerobic capacity) in people with chronic pain classified as regional or widespread and to compare the findings with a group that report no pain.

Methods From the 2016 follow-up of the Swedish population based Epipain cohort (n 1321), 146 subjects were invited to a clinical assessment where the aerobic capacity was assessed by using a submaximal bicycle test, the Ekblom-Bak test, together with assessment of the Borg scale for perceived exertion (RPE). Aerobic capacity was also classified as low, average or high according to data from the general population. Self-reported physical activity was coded as MVPArec if recommended levels of PA was reported (physically active on a moderate level ≥150 min/week (MPA) or on an vigorous level ≥75 min/week (VPA) or not). The Fear Avoidance Beliefs Questionnaire for PA (FABQ-PA, 0–24 best to worst) and for work (FABQ-W, 0–48 best to worst) were also assessed. The participants were classified as having chronic widespread pain (CWP), chronic regional pain (CRP) or no chronic pain (NCP) based on a pain mannequin presenting 0–18 pain regions and if pain had lasted for 3 months or more. Chi2 and Kruskal-Wallis tests were performed to study differences between the three pain groups.

Results 141/146 (97%) subjects (mean (SD) age 59.4 (8.2) years) whereof 61% were women, could be classified into pain groups; 43 as CWP (84% women), 43 as CRP (42% women) and 55 as NCP (58% women). The group with CWP was slightly older than those with CRP (mean (SD) age 57.0 (7.6) years vs. 61.9 (6.9) years, p 0.02). The CWP group also had lower aerobic capacity (mean (SD) 2.2 (0.5) l/min vs. 2.6 (0.6) l/min, p 0.03), and a larger proportion was classified as having low aerobic capacity (CWP 21%, CRP 7% and NCP 10%, p 0.04). The proportion of MVPArec did not differ between the groups; CWP 70%, CRP 81% and NCP 74% (p 0.5). There was neither a difference between the groups in BMI, RPE or in sitting hours/week (p>0.6). However, differences were found in the FABQ where in the PA scale those with CRP had worse scores compared with NCP (mean (SD) 11.2 (7.3) vs. 6.0 (6.0), p<0.001), the difference between CWP (mean (SD) 8.9 (6.7)) and NCP was p 0.06. In the work subscale of FABQ, CWP had worse scores compared with CRP (mean (SD) 18.9 (15.7) vs. 10.0 (12.5), p 0.002) and CRP had worse scores compared to those with NCP (mean (SD) 10.0 (12.5) vs. 6.5 (9.1), p<0.001).

Conclusions In this sample of subjects with chronic pain or no pain, having widespread pain tended to affect the aerobic capacity negatively while self-reports of reaching recommended levels of physical activity did not differ between groups. Fear avoidance in relation to physical activity and especially in relation to work was more noticeable in subjects with chronic pain compared to those with no pain. Measures of aerobic capacity and information of fear avoidance beliefs might help health professionals to better tailor the non-pharmacological treatment for subjects with chronic pain.

Disclosure of Interest None declared

© 2018, Published by the BMJ Publishing Group Limited.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2018
National Category
Clinical Medicine Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:hh:diva-36809 (URN)
Conference
Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018
Available from: 2018-05-23 Created: 2018-05-23 Last updated: 2018-07-30Bibliographically approved
Malmborg, J., Olsson, M. C., Bergman, S. & Bremander, A. (2018). Musculoskeletal pain and its association with maturity and sports performance in 14-year-old sport school students. BMJ Open Sport & Exercise Medicine, 4(1), Article ID e000395.
Open this publication in new window or tab >>Musculoskeletal pain and its association with maturity and sports performance in 14-year-old sport school students
2018 (English)In: BMJ Open Sport & Exercise Medicine, ISSN 2055-7647, Vol. 4, no 1, article id e000395Article in journal (Refereed) Published
Abstract [en]

Objectives: In youth sports, musculoskeletal pain is often studied from the standpoint of sports injuries, but little is known about pain conditions in which athletes still participate. The aim was to study the frequency of pain and associations with maturity offset, health status and sports performance in 14-year-old sport school students.

Methods: Cross-sectional design. One hundred and seventy-eight students (108 boys and 70 girls) completed anthropometric measures for maturity offset (height, weight and sitting height), questionnaires (pain mannequin and EQ-5D for health status) and sports performance tests (sprint, agility, counter-movement jump and grip strength). Differences between groups were analysed with Student’s t-test and analysis of covariance.

Results: Thirty-one students (18.6%) reported infrequent pain, 85 (50.9%) frequent pain and 51 (30.5%) constant pain. Students in the constant pain group had worse health status than those in the infrequent pain group. Boys with constant pain (n=27) had a lower mean maturity offset (–0.38 vs 0.07 years; p=0.03) than boys with infrequent pain (n=22), and pain was associated with worse sports performance. There was no difference in maturity or sports performance between girls with constant pain (n=24) and girls with infrequent pain (n=9).

Conclusion: Musculoskeletal pain is common in sport school students and coincides with worse health status and with a younger biological age in boys. The high prevalence of pain should be acknowledged by coaches and student healthcare workers in order to promote a healthy and sustainable development in young athletes. © Author(s) (or their employer(s)) 2018.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology Sport and Fitness Sciences
Identifiers
urn:nbn:se:hh:diva-37488 (URN)10.1136/bmjsem-2018-000395 (DOI)
Note

Funding: Halmstad University; Spenshult Research and Development Center, Halmstad; Region Halland (grant numbers HALLAND-469111 and HALLAND-639101); and the Mayflower Charity Foundation, Sweden.

Available from: 2018-07-04 Created: 2018-07-04 Last updated: 2018-07-05Bibliographically approved
Larsson, I., Andersson, M. L., Ajeganova, S., Bala, V., Svensson, B., Bergman, S., . . . ֖stenson, A. (2018). Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: A mixed-methods study. BMJ Open, 8(12), Article ID e024367.
Open this publication in new window or tab >>Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: A mixed-methods study
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 12, article id e024367Article in journal (Refereed) Published
Abstract [en]

Objectives: The aims were to identify patients with rheumatoid arthritis (RA) who had stopped drinking alcohol and compare them with patients drinking alcohol, and to explore reasons for stopping drinking alcohol. Design: A sequential explanatory mixed methods design was used. Setting: Six rheumatology clinics in Southern Sweden Better Anti-Rheumatic FarmacOTherapy cohort. Participants: A total of 1509 patients completed the questions about alcohol and were included in the study. 86 of these had stopped drinking alcohol and 72 responded to the open question and their answers were analysed with qualitative content analysis. Outcome measures: The quantitative data were from a cross-sectional survey assessing disease severity, physical function (Health Assessment Questionnaire, HAQ) and health-related quality of life (EuroQol five dimensions, EQ5D), pain, fatigue, patient global assessment (PatGA) and lifestyle factors, for example, alcohol. The questions assessing alcohol included an open question ’Why have you stopped drinking alcohol?’ Results: The patients who stopped drinking alcohol were older (median (min-max) 69 (36-90) vs 66 (23-95), p=0.011), had worse HAQ (1.00 (0-2.75) vs 0.50 (0-3.00), p<0.001), worse EQ5D (0.69 (-0.02-1.00) vs 0.76 (-0.58-1.00), p<0.001) worse PatGA (5 (0-10) vs 3 (0-10), p<0.001), more pain (5 (0-10) vs 3 (0-10), p<0.001) and more fatigue (6 (0-10) vs 4 (0-10), p<0.001 compared with patients drinking alcohol. The qualitative content analysis revealed five categories describing reasons for patients with RA to stop drinking alcohol: illness and treatment; health and well-being; work and family; faith and belief; and dependences and abuse. Conclusions: The patients who had stopped drinking had worse physical functioning and higher levels in pain-related variables. Most stopped drinking due to their illness or a desire to improve health. © 2018 Author(s).

Place, publisher, year, edition, pages
BMJ Publishing Group, 2018
Keywords
qualitative research, rheumatology
National Category
Substance Abuse Nursing
Identifiers
urn:nbn:se:hh:diva-38698 (URN)10.1136/bmjopen-2018-024367 (DOI)2-s2.0-85058786151 (Scopus ID)
Note

For the BARFOT study group

Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved
Aili, K., Andersson, M., Bremander, A., Haglund, E., Larsson, I. & Bergman, S. (2018). Sleep problems and fatigue as a predictor for the onset of chronic widespread painover a 5- and 18-year perspective: a 20-year prospective study. Paper presented at Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018. Annals of the Rheumatic Diseases, 77, 87-87, Article ID OP0072.
Open this publication in new window or tab >>Sleep problems and fatigue as a predictor for the onset of chronic widespread painover a 5- and 18-year perspective: a 20-year prospective study
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, p. 87-87, article id OP0072Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: If localised pain represent one end of a pain spectra, with overall better general health, chronic widespread pain (CWP) and fibromyalgia represent the other end of the spectra with worse general health and more comorbidities with other somatic diseases and mental illness. Sleep problems and fatigue are common among individuals reporting CWP and previous research indicate that sleep problems may be an important predictor for pain prognosis.

Objectives: The aim of this population-based study was to investigate if sleep problems and fatigue predict the onset of CWP 5 and 18 years later.

Methods: In order to get more stable baseline classifications of CWP, a wash-out period was used, including only individuals who had not reported CWP (according to ACR 1990 criteria for fibromyalgia) at baseline (−98) and three years prior baseline (−95). In all, data from 1249 individuals entered the analyses for the 5 year follow-up (−03) and 791 entered for the 18 year follow-up (−16). Four parameters related to sleep (difficulties initiating sleep, maintaining sleep, early morning awakening and non-restorative sleep), and one parameter related to fatigue (SF-36 vitality scale) were investigated as predictors for CWP. Binary logistic regression analysis were used for analyses.

Results: All investigated parameters predicted the onset of CWP five years later (problems with initiating sleep (OR 1.91; 1.16–3.14), maintaining sleep (OR 1.85; 1.14–3.01), early awakening (OR 2.0; 1.37–3.75), non-restorative sleep (OR 2.27; 1.37–3.75) and fatigue (OR 3.70; 1.76–7.84)) in a model adjusted for age, gender, socio-economy and mental health. All parameters except problems with early awakening predicted the onset of CWP also 18 years later. In all, 785 individuals did not report any of the sleeping problems at baseline (fatigue not included), 268 reported one of the problems, 167 two, 128 three and 117 subjects reported to have all four sleep problems. Reporting all four sleep problems was significantly associated with CWP at follow-up at both time points when adjusting for age, gender, socio economy and mental health (OR 4.00; 2.03–7.91 and OR 3.95; 1.90–8.20); adjusting for age, gender, socio economy and number of pain regions (OR 2.94; 1.48–5.82 and OR 2.65; 1.24–5.64) and in a model adjusting for age, gender, socio economy and pain severity (OR 2.97;1.53–5.76; and OR 3.02;1.47–6.21) for the 5 year and 18 year follow-up respectively, compared to not reporting any of the sleep problems at baseline.

Conclusions: Both sleeping problems and fatigue predicts the onset of CWP 5- and 18 years later. The results highlight the importance of the assessment of sleep quality in the clinic.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2018
Keywords
Chronic widespread pain, Sleep problems
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-37138 (URN)
Conference
Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018
Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-07-26Bibliographically approved
Aili, K., Andersson, M., Bremander, A., Haglund, E., Larsson, I. & Bergman, S. (2018). Sleep problems and fatigue as predictorsfor the onset of chronic widespread painover a 5- and 18-year perspective. BMC Musculoskeletal Disorders, 19(1), 1-14
Open this publication in new window or tab >>Sleep problems and fatigue as predictorsfor the onset of chronic widespread painover a 5- and 18-year perspective
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2018 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, no 1, p. 1-14Article in journal (Refereed) Published
Abstract [en]

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. © The Author(s). 2018

Place, publisher, year, edition, pages
London: BioMed Central, 2018
Keywords
Musculoskeletal pain, Insomnia, CWP, Prospective study, Longitudinal study, Population study
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-38256 (URN)10.1186/s12891-018-2310-5 (DOI)30390670 (PubMedID)
Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2018-11-08Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6294-538X

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