title: Sleep problems, exercise and obesity and risk of chronic musculoskeletal pain: the Norwegian HUNT study.
abstract: BACKGROUND
  The objective was to investigate the association between self-reported sleep problems and risk of chronic pain in the low back and neck/shoulders, and whether physical exercise and body mass index (BMI) alter this association.
  
  
  METHODS
  The study comprised data on 26 896 women and men in the Nord-Trøndelag Health Study (Norway) without chronic pain or physical impairment at baseline in 1984-86. Occurrence of chronic pain was assessed at follow-up in 1995-97. A generalized linear model was used to calculate adjusted risk ratios.
  
  
  RESULTS
  Sleep problems were dose-dependently associated with risk of pain in the low back and neck/shoulders in both women and men (P < 0.001 both genders). Women and men who reported sleep problems 'sometimes' and 'often/always' had a higher risk of chronic pain of 23-32% and 51-66%, respectively, than those who reported sleep problems 'never'. Combined analyses showed that persons with sleep problems 'sometimes' and who exercised ≥1 hour per week had lower risk of chronic pain in the low back (P < 0.04) and neck/shoulders (P < 0.001) than inactive persons with a similar level of sleep problems (P < 0.04). Likewise, persons with BMI <25 kg/cm(2) and sleep problems 'sometimes' had lower risk of chronic pain in the low back (P < 0.001) and neck/shoulders (P < 0.001) than persons with BMI ≥25 kg/cm(2) and a similar level of sleep problems.
  
  
  CONCLUSIONS
  Sleep problems are associated with an increased risk of chronic pain in the low back and neck/shoulders. Regular exercise and maintenance of normal body weight may reduce the adverse effect of mild sleep problems on risk of chronic pain.
authors.affiliation: 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway paul.mork@svt.ntnu.no.
authors.forename: Paul Jarle
authors.initials: PJ
authors.lastname: Mork
authors.affiliation: 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway 2 Liaison Committee between the Central Norway Regional Health Authority (RHA), Stjørdal, Norway, and the Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
authors.forename: Kirsti Lund
authors.initials: KL
authors.lastname: Vik
authors.affiliation: 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Børge
authors.initials: B
authors.lastname: Moe
authors.affiliation: 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway 2 Liaison Committee between the Central Norway Regional Health Authority (RHA), Stjørdal, Norway, and the Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Lier
authors.affiliation: 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Ellen Marie
authors.initials: EM
authors.lastname: Bardal
authors.affiliation: 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Tom Ivar Lund
authors.initials: TI
authors.lastname: Nilsen
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000453:epidemiology; D059350:Chronic Pain / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology*; D019547:Neck Pain / Q000453:epidemiology; D009664:Norway / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D020069:Shoulder Pain / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000453:epidemiology*