title: Characteristics of chronic pain associated with sleep difficulty in older adults: the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston study.
abstract: OBJECTIVE
  To evaluate pain severity and distribution in relation to sleep difficulty in older adults.
  
  
  METHODS
  Population-based cross-sectional study.
  
  
  METHODS
  Community within a 5-mile radius of the study center at the Institute for Aging Research, Hebrew SeniorLife (HSL), Boston.
  
  
  METHODS
  Seven hundred sixty-five participants of the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston Study aged 64 and older.
  
  
  METHODS
  Pain severity was measured using the Brief Pain Inventory (BPI) Pain Severity Subscale. Musculoskeletal pain distribution was grouped according to no pain, single site, two or more sites, and widespread pain (upper and lower extremities and back pain). Three aspects of sleep difficulty were measured using items from the Center for Epidemiologic Studies Depression Scale, Revised (trouble getting to sleep, sleep more than usual, and restless sleep).
  
  
  RESULTS
  Prevalence of trouble getting to sleep according to BPI severity was 17.8%, 19.7%, 32.0%, and 37.0% for the lowest to highest pain severity quartiles, respectively. Similar relationships between pain and sleep were observed across sleep measures according to pain severity and distribution. Adjusted for sociodemographic characteristics, chronic conditions, and health behaviors, chronic pain was strongly associated with trouble sleeping (≥ 1 d/wk) (single-site pain, odds ratio (OR)=1.77, 95% confidence interval (CI)=1.10-2.87; multisite pain, OR=2.38, 95% CI=1.48-3.83; widespread pain, OR=2.55, 95% CI=1.43-4.54, each compared with no pain). Similar associations were observed for restless sleep and sleeping more than usual. For specific pain sites alone or in combination with other sites of pain, only modest associations were observed with sleep problems.
  
  
  CONCLUSIONS
  Widespread or other multisite pain and moderate to severe pain are strongly associated with sleep difficulty in older adults. Further research is needed to better understand the burden and consequences of pain-related sleep problems in older adults.
authors.affiliation: College of Nursing and Health Sciences, University of Massachusetts Boston, Massachusetts, USA.
authors.forename: Qian
authors.initials: Q
authors.lastname: Chen
authors.forename: Laura L
authors.initials: LL
authors.lastname: Hayman
authors.forename: Robert H
authors.initials: RH
authors.lastname: Shmerling
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Bean
authors.forename: Suzanne G
authors.initials: SG
authors.lastname: Leveille
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D001900:Boston; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006306:Health Surveys; D006331:Heart Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D008171:Lung Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D010003:Osteoarthritis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D010146:Pain / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement / Q000145:classification / Q000523:psychology; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D004856:Postural Balance / Q000502:physiology*; D019413:Qi; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D013130:Spinal Stenosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology