Sleep disturbances predict future sickness absence among individuals with lower back or neck-shoulder pain: a 5-year prospective study.
BACKGROUND
Musculoskeletal pain is one of the most common causes of sickness absence. Sleep disturbances are often co-occurring with pain, but the relationship between sleep and pain is complex. Little is known about the importance of self-reported sleep, when predicting sickness absence among persons with musculoskeletal pain. This study aims to study the association between self-reported sleep quality and sickness absence 5 years later, among individuals stratified by presence of lower back pain (LBP) and neck and shoulder pain (NSP).


METHODS
The cohort (n = 2286) in this 5-year prospective study (using data from the MUSIC-Norrtälje study) was stratified by self-reported pain into three groups: no LBP or NSP, solely LBP or NSP, and concurrent LBP and NSP. Odds ratios (ORs) for the effect of self-reported sleep disturbances at baseline on sickness absence (> 14 consecutive days), 5 years later, were calculated.


RESULTS
Within all three pain strata, individuals reporting the most sleep problems showed a significantly higher OR for all-cause sickness absence, 5 years later. The group with the most pronounced sleep problems within the concurrent LBP and NSP stratum had a significantly higher OR (OR 2.00; CI 1.09-3.67) also for long-term sickness absence (> 90 days) 5 years later, compared to the group with the best sleep. CONCLUSIONS Sleep disturbances predict sickness absence among individuals regardless of co-existing features of LBP and/or NSP. The clinical evaluation of patients should take possible sleep disturbances into account in the planning of treatments.
Karolinska Instutitet, Institute of Environmental Medicine, Stockholm, Sweden Katarina.aili@ki.se.
Katarina
K
Aili
Karolinska Instutitet, Institute of Environmental Medicine, Stockholm, Sweden KTH Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
Teresia
T
Nyman
Karolinska Instutitet, Institute of Environmental Medicine, Stockholm, Sweden.
Lena
L
Hillert
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Magnus
M
Svartengren
D000328:Adult; D005260:Female; D005544:Forecasting; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology*; D011446:Prospective Studies; D057566:Self Report; D020069:Shoulder Pain / Q000453:epidemiology*; D018582:Sick Leave / Q000639:trends*; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
musculoskeletal pain; occupational health; pain; predictors; public health; risk factors; sleep; sleep quality; spinal pain; work ability