title: Sleeping problems as a risk factor for subsequent musculoskeletal pain and the role of job strain: results from a one-year follow-up of the Malmö Shoulder Neck Study Cohort.
abstract: BACKGROUND
  The role of sleeping problems in the causal pathway between job strain and musculoskeletal pain is not clear.
  
  
  OBJECTIVE
  To investigate the impact of sleeping problems and job strain on the one-year risk for neck, shoulder, and lumbar pain.
  
  
  METHODS
  A prospective study, using self-administered questionnaires, of a healthy cohort of 4,140 vocationally active persons ages 45-64, residing in the city of Malmo.
  
  
  RESULTS
  At follow-up, 11.8% of the men and 14.8% of the women had developed pain. The odds ratios (OR) for pain at follow-up and sleeping problems at baseline were 1.72 (95% CI: 1.13-2.61) in men and 1.91 (1.35-2.70) in women. Regarding exposure to job strain, ORs were 1.39 (0.94-2.05) for men and 1.63 (1.18-2.23) for women. These statistically significant risks remained so when controlled for possible confounding. A modest synergistic effect was noted in women with concurrent sleeping problems and job strain, but not in men.
  
  
  CONCLUSIONS
  One in 15-20 of all new cases of chronic pain in the population could be attributed to sleeping problems. No evidence was found for a causal chain with job strain leading to musculoskeletal pain by the pathway of sleeping problems.
authors.affiliation: Division of General Practice, Department of Clinical Sciences Malmo, Lund University, Malmö , Sweden. catarina.canivet@med.lu.se
authors.forename: Catarina
authors.initials: C
authors.lastname: Canivet
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Ostergren
authors.forename: Bongkyoo
authors.initials: B
authors.lastname: Choi
authors.forename: Peter
authors.initials: P
authors.lastname: Nilsson
authors.forename: Ulrika
authors.initials: U
authors.lastname: af Sillén
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Moghadassi
authors.forename: Robert
authors.initials: R
authors.lastname: Karasek
authors.forename: Sven-Olof
authors.initials: SO
authors.lastname: Isacsson
mesh_terms: D001416:Back Pain / Q000453:epidemiology / Q000523:psychology*; D015984:Causality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology / Q000523:psychology*; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020069:Shoulder Pain / Q000453:epidemiology / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D013548:Sweden; D016526:Workload / Q000523:psychology* / Q000706:statistics & numerical data