Sarah C Griffin1, Scott G Ravyts2, Elizaveta Bourchtein3, Christi S Ulmer4, Melanie K Leggett5, Joseph M Dzierzewski2, Patrick S Calhoun6. 1. Durham Veterans Affairs Health Care System, Durham, NC, USA; Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Health Care System, Durham, NC, USA. Electronic address: sarah.griffin2@va.gov. 2. Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA. 3. Division of Pediatric Psychology, Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA. 4. Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Health Care System, Durham, NC, USA; Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA. 5. Durham Veterans Affairs Health Care System, Durham, NC, USA; Division of Adult Psychiatry and Psychology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. 6. Durham Veterans Affairs Health Care System, Durham, NC, USA; Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
Abstract
OBJECTIVE: To examine the relationship between sleep disturbance and pain over a 14-year period. METHODS: This study used data from the 2002-2016 waves of the Health and Retirement Study (HRS), an observational study of U.S. adults over age 50 (n = 17,756). Sleep disturbance was measured via four items (assessing difficulty falling asleep, staying asleep, and waking up too early as well as restedness) and pain via two items assessing the presence and degree of pain. Analyses consisted of path analysis; more specifically, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine how pain and sleep disturbance predict one another over two-year intervals after accounting for the trait-like nature of both factors. RESULTS: There was evidence of reciprocal effects between sleep disturbance and pain across some, but not all, intervals. Moreover, the latent variables representing the trait-like nature of sleep disturbance and pain both showed significant variance (p < 0.001), indicating stable differences between persons in sleep and pain. These trait-like characteristics were strongly associated (β = 0.51, p < 0.001). The findings remained after adjusting the model for baseline age, self-reported health, partner status, depression, years of education, and sex. CONCLUSION: Sleep disturbance and pain are stable experiences. Moreover, there was some evidence that sleep disturbance and pain are bidirectionally linked across time among adults over 50, whereby across some intervals deviations in one's typical level of sleep disturbance predicted corresponding deviations in one's typical level of pain and vice versa. Clinically, this comorbidity and potential longitudinal bidirectionality underscore the importance of evidence-based interventions that target both sleep and pain among older individuals. Further studies should replicate these findings by collecting validated and/or objective sleep and pain measures on a more frequent basis. Published by Elsevier B.V.
OBJECTIVE: To examine the relationship between sleep disturbance and pain over a 14-year period. METHODS: This study used data from the 2002-2016 waves of the Health and Retirement Study (HRS), an observational study of U.S. adults over age 50 (n = 17,756). Sleep disturbance was measured via four items (assessing difficulty falling asleep, staying asleep, and waking up too early as well as restedness) and pain via two items assessing the presence and degree of pain. Analyses consisted of path analysis; more specifically, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine how pain and sleep disturbance predict one another over two-year intervals after accounting for the trait-like nature of both factors. RESULTS: There was evidence of reciprocal effects between sleep disturbance and pain across some, but not all, intervals. Moreover, the latent variables representing the trait-like nature of sleep disturbance and pain both showed significant variance (p < 0.001), indicating stable differences between persons in sleep and pain. These trait-like characteristics were strongly associated (β = 0.51, p < 0.001). The findings remained after adjusting the model for baseline age, self-reported health, partner status, depression, years of education, and sex. CONCLUSION: Sleep disturbance and pain are stable experiences. Moreover, there was some evidence that sleep disturbance and pain are bidirectionally linked across time among adults over 50, whereby across some intervals deviations in one's typical level of sleep disturbance predicted corresponding deviations in one's typical level of pain and vice versa. Clinically, this comorbidity and potential longitudinal bidirectionality underscore the importance of evidence-based interventions that target both sleep and pain among older individuals. Further studies should replicate these findings by collecting validated and/or objective sleep and pain measures on a more frequent basis. Published by Elsevier B.V.
Authors: James Dahlhamer; Jacqueline Lucas; Carla Zelaya; Richard Nahin; Sean Mackey; Lynn DeBar; Robert Kerns; Michael Von Korff; Linda Porter; Charles Helmick Journal: MMWR Morb Mortal Wkly Rep Date: 2018-09-14 Impact factor: 17.586