title: Exploring the associations between sleep problems and chronic musculoskeletal pain in adolescents: a prospective cohort study.
abstract: BACKGROUND
  The prevalence of musculoskeletal chronic pain in adolescents is estimated to be approximately 4% to 40%. The development of musculoskeletal pain during teenage years could have a marked impact on physical, psychological and social well-being.
  
  
  OBJECTIVE
  To examine whether sleep problems during adolescence are associated with musculoskeletal pain, particularly chronic regional pain and chronic widespread pain.
  
  
  METHODS
  Using data from the Avon Longitudinal Study of Children, the relationship between sleep problems at 15 years of age and the presence of chronic regional and widespread pain at 17 years of age was explored. Pain data were not available at 15 years of age. A total of 2493 participants with complete data were identified. Relationships among sleep problems and musculoskeletal pain were examined using logistic regression. ORs were calculated after adjusting for sex, ethnicity, socioeconomic position and depression (15 years of age).
  
  
  RESULTS
  Sleep disturbance (usually wakes up more than two or three times), difficulties with hypersomnolence and poor subjective sleep perception were associated with the presence of both musculoskeletal regional and widespread pain. Finally, using ordered logistic regression, poor subjective sleep perception was also found to be associated with greater pain severity in participants with chronic musculoskeletal regional and widespread pain.
  
  
  CONCLUSIONS
  The results of the present study suggest an association between sleep problems during adolescence and the presence of musculoskeletal pain at a later stage. These findings are consistent with adult literature suggesting a link between sleep problems and musculoskeletal pain. Given these associations, sleep problems in adolescence may be an important risk factor for musculoskeletal pain.
authors.forename: Lee
authors.initials: L
authors.lastname: Harrison
authors.forename: Sue
authors.initials: S
authors.lastname: Wilson
authors.forename: Marcus R
authors.initials: MR
authors.lastname: Munafò
mesh_terms: D000293:Adolescent; D000367:Age Factors; D059350:Chronic Pain / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000150:complications*; D016017:Odds Ratio; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology*