title: Pain-related and Psychological Symptoms in Adolescents With Musculoskeletal and Sleep Problems.
abstract: OBJECTIVE
  Two-thirds of adolescents with chronic musculoskeletal pain report a concurrent sleep problem. Both musculoskeletal pain and sleep problems can have deleterious effects on physiological and psychological well-being. We explored the prevalence of sleep problems and musculoskeletal pain, using data on 3568 adolescents from the Avon Longitudinal Study of Children.
  
  
  METHODS
  A comprehensive battery of questionnaires was administered to derive clinical phenotypes of musculoskeletal pain. Adolescents with single symptoms were compared with those reporting both musculoskeletal pain and sleep problems. Linear and logistic regression analyses were used to compare groups on pain-related variables and psychological complaints. The association between sociodemographic variables and comorbid musculoskeletal pain and sleep problems was assessed using logistic regression.
  
  
  RESULTS
  Over half the sample was female (n=2076, 58.2%) and the majority of European ancestry (n=3174, 97.7%). Only 5.5% (n=196) of participants were identified as having a pain condition, while 21.2% (n=749) reported a significant sleep problem, and 2.8% (n=99) reported comorbid musculoskeletal pain and sleep problems. Adolescents with comorbid problems experienced greater pain intensity and pain-related anxiety. Other psychological complaints were also higher in those who experienced concurrent problems, including depression, fatigue, concentration, and overall severity of psychological symptoms.
  
  
  CONCLUSIONS
  Comorbid sleep and pain problems were associated with a higher incidence of pain-related and psychological symptoms. Sleep problems may therefore be an important modifiable risk factor for alleviating distress in adolescents with musculoskeletal pain.
authors.affiliation: *School of Social and Community Medicine ‡MRC Integrative Epidemiology Unit, University of Bristol §UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol †Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK.
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; D001007:Anxiety; D018771:Arthralgia; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D000297:Psychology, Adolescent / Q000706:statistics & numerical data*; D018570:Risk Assessment; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000523:psychology*; D006113:United Kingdom / Q000453:epidemiology