Chronic painful physical conditions, disturbed sleep and psychiatric morbidity: results from an elderly survey.
BACKGROUND
The main purpose of this study is to investigate the association of disturbed sleep, chronic physical pain and psychiatric morbidity in people aged 60 years and over.


METHODS
A population-based random sample of 7040 household residents aged 60 years and over, was examined in a face-to-face interview. Painful medical conditions were assessed through questions evaluating medical treatment, hospitalizations, and consultations for medical problems. Disturbed sleep was assessed through questions concerning the presence of sleeping problems in the past 4 weeks.


RESULTS
The overall prevalence of disturbed sleep is 33.7% (95% CI: 32.5-34.8) and the 6-month prevalence of any chronic pain was 76.2% (95% CI: 74.2-78.2%). A substantial burden of disturbed sleep is associated with the presence of physical pain morbidity, 42.5% for back pain to 49.7% for headaches. The prevalence of pain among persons with disturbed sleep ranges from 25.8% for gastrointestinal pain to 54.6% for joint pain. The presence of comorbid pain and disturbed sleep has an important disability impact as assessed by socioecomomic/professional data, health care utilization, self-rated health and physical activity. In logistic regression models, headaches, psychiatric morbidity, rural origin, Caucasians, self-rated health and number of chronic pain conditions were significantly associated with disturbed sleep after controlling for demographic variables and comorbidities. Age has a negative effect on sleep complaints.


CONCLUSIONS
Disturbed sleep is highly comorbid with other pain conditions particularly headaches and psychiatric morbidity in later life. The combination of pain and disturbed sleep leads to important role disability and increased utilization of medical services.
Blay
Sergio Luís
SL
Department of Psychiatry, Federal University of São Paulo, Brazil. blay@uol.com.br
Andreoli
Sergio Baxter
SB
Gastal
Fábio Leite
FL
D000368:Aged; D001416:Back Pain / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002637:Chest Pain / Q000453:epidemiology; D002908:Chronic Disease; D005260:Female; D006261:Headache / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D010146:Pain / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D012959:Socioeconomic Factors