title: Bidirectionality between pain and insomnia symptoms: a prospective study.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether there is a bidirectional relationship between pain and insomnia symptoms over the course of a year.
  
  
  METHODS
  A longitudinal design with a 1-year follow-up was used.
  
  
  METHODS
  From a randomly selected sample of the adult general population (N= 3,000), 1,746 individuals filled out a baseline and 1-year follow-up survey on pain, insomnia symptoms, anxiety symptoms, and depressive symptoms.
  
  
  RESULTS
  Pain (OR = 1.64) and anxiety symptoms increased the risk for the incidence of insomnia symptoms (R(2) = .125) and pain (OR = 1.98), anxiety symptoms and depressive symptoms were related to the persistence of insomnia symptoms (R(2) = .212). Gender and anxiety symptoms increased the risk for the incidence of pain (R(2) = .073); and age, insomnia symptoms (OR = 1.49), anxiety symptoms, and depressive symptoms were associated with the persistence of pain (R(2) = .187).
  
  
  CONCLUSIONS
  While pain was linked to future insomnia symptoms and insomnia symptoms to the persistence of pain over the course of a year, insomnia symptoms was not associated with the incidence of pain. The results, thus, partly argue against bidirectionality between pain and insomnia symptoms.
authors: Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Sweden. markus.jansson@oru.se
authors: Markus
authors: M
authors: Jansson-Fröjmark
authors: Katja
authors: K
authors: Boersma
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000150:complications*; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications* / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000523:psychology*; D011795:Surveys and Questionnaires