title: Musculoskeletal Pain as a Marker of Health Quality. Findings from the Epidemiological Sleep Study among the Adult Population of São Paulo City.
abstract: We are witnessing the growth of urban populations, particularly in the developing world. São Paulo, the largest city in South America, continues to grow, and this growth is dramatically effecting the environment and human health. The aim of this study was to estimate the point prevalence of chronic pain in São Paulo city dwellers and to explore the influence of aspects related to urbanicity.
  
  
  
  A two-stage cluster randomized sample included 1100 individuals of the city of Sao Paulo, representing the population proportionally in terms of gender, age and social classes in 2007. For this observational cross-sectional study, the household sample was interviewed using validated questionnaires for sociodemographic aspects, the Beck inventories for anxiety and depression, the WHOQoL-REF for quality of life, the Chalder Fatigue Scale. Musculoskeletal pain was defined as diffuse pain or pain located in the back, joints or limbs. Data regarding sleep complaints and polysomnography were obtained from the Epidemiologic Sleep Study conducted in São Paulo city in 2007.
  
  
  
  The prevalence estimate of chronic musculoskeletal pain was approximately 27%, with a female/male ratio of approximately 2.6/1. The predictors were being in the age-range of 30-39 years, low socioeconomic and schooling levels, obesity, sedentarism, fatigue, non-restorative sleep, daytime sleepiness, poor sleep quality, poor life quality, anxiety and depression symptoms. Psychological wellbeing was the main discriminator between responders with chronic musculoskeletal pain and the controls, followed by depression for the participants with poor psychological wellbeing, and fatigue, for the remaining ones. Insomnia syndrome was the third-level discriminator for those with fatigue, whereas sleep quality for those without fatigue.
  
  
  
  Musculoskeletal pain was frequently reported by São Paulo city dwellers and its correlates with psychological and sleep aspects are suggestive of a response to urbanicity.
  
  
  
  ClinicalTrials.gov NCT00596713.
authors.affiliation: Department of Internal Medicine, UNIFESP, São Paulo, Brazil.
authors.forename: Suely
authors.initials: S
authors.lastname: Roizenblatt
authors.affiliation: Department of Psychobiology, UNIFESP, São Paulo, Brazil.
authors.forename: Altay L
authors.initials: AL
authors.lastname: Souza
authors.affiliation: Department of Psychobiology, UNIFESP, São Paulo, Brazil.
authors.forename: Luciana
authors.initials: L
authors.lastname: Palombini
authors.affiliation: Department of Psychobiology, UNIFESP, São Paulo, Brazil.
authors.forename: Luciana M
authors.initials: LM
authors.lastname: Godoy
authors.affiliation: Department of Psychobiology, UNIFESP, São Paulo, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
authors.affiliation: Department of Psychobiology, UNIFESP, São Paulo, Brazil.
authors.forename: Lia Rita A
authors.initials: LR
authors.lastname: Bittencourt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology; D001938:Brazil; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000503:physiopathology; D017286:Polysomnography; D011788:Quality of Life; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population