Sleep problems and fatigue as predictors for the onset of chronic widespread pain over a 5-and 18-year perspective

被引:42
作者
Aili, Katarina [1 ,2 ,7 ]
Andersson, Maria [1 ,3 ]
Bremander, Ann [1 ,3 ,4 ,5 ,6 ]
Haglund, Emma [1 ,4 ]
Larsson, Ingrid [1 ,7 ]
Bergman, Stefan [1 ,7 ,8 ]
机构
[1] FoU Spenshult, Spenshult Res & Dev Ctr, Backagardsvagen 47, SE-30274 Halmstad, Sweden
[2] Karolinska Inst, Inst Environm Med, Unit Occupat Med, Stockholm, Sweden
[3] Lund Univ, Dept Clin Sci, Sect Rheumatol, Lund, Sweden
[4] Halmstad Univ, Sch Business Engn & Sci, Halmstad, Sweden
[5] Univ Southern Denmark, Dept Reg Hlth Res, Odense, Denmark
[6] Syddansk Univ, Hosp Southern Jutland, King Christian X Hosp Rheumat Dis, Res Unit, Copenhagen, Graasten, Denmark
[7] Halmstad Univ, Sch Hlth & Welf, Halmstad, Sweden
[8] Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med,Primary Hlth Care, Gothenburg, Sweden
关键词
Musculoskeletal pain; Insomnia; CWP; Prospective study; Longitudinal study; Population study; SF-36 HEALTH SURVEY; MUSCULOSKELETAL PAIN; RISK-FACTORS; FOLLOW-UP; GENERAL-POPULATION; SWEDISH POPULATION; PROSPECTIVE COHORT; MULTISITE PAIN; QUALITY; FIBROMYALGIA;
D O I
10.1186/s12891-018-2310-5
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
BackgroundPrevious 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.MethodsTo 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.ResultsThe 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 18years 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.ConclusionSleep 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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页数:14
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