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Sleep problems and fatigue as predictorsfor the onset of chronic widespread painover a 5- and 18-year perspective
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport. Spenshult Research and Development Center, FoU Spenshult, Halmstad, Sweden & Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0003-4260-7399
Spenshult Research and Development Center, FoU Spenshult, Halmstad, Sweden & Lunds Universitet, Lund, Sweden.
Spenshult Research and Development Center, FoU Spenshult, Halmstad, Sweden & Lunds Universitet, Lund, Sweden & University of Southern Denmark, Odense, Denmark & Syddansk Universitet, Graasten, Danmark.ORCID iD: 0000-0002-8081-579X
Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Spenshult Research and Development Center, FoU Spenshult, Halmstad, Sweden.ORCID iD: 0000-0002-1445-5247
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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. Vol. 19, no 1, p. 1-14
Keywords [en]
Musculoskeletal pain, Insomnia, CWP, Prospective study, Longitudinal study, Population study
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hh:diva-38256DOI: 10.1186/s12891-018-2310-5PubMedID: 30390670OAI: oai:DiVA.org:hh-38256DiVA, id: diva2:1260687
Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2018-11-08Bibliographically approved

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Aili, KatarinaBremander, AnnHaglund, EmmaLarsson, IngridBergman, Stefan

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Aili, KatarinaBremander, AnnHaglund, EmmaLarsson, IngridBergman, Stefan
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Health and SportThe Rydberg Laboratory for Applied Sciences (RLAS)Health and NursingCentre of Research on Welfare, Health and Sport (CVHI)
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BMC Musculoskeletal Disorders
Public Health, Global Health, Social Medicine and Epidemiology

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