Pain-related and Psychological Complaints in Adolescents with Musculoskeletal and Sleep Problems

OBJECTIVES: 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 3,568 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 co-morbid musculoskeletal pain and sleep problems was assessed using logistic regression.

RESULTS: Over half the sample was female (n = 2,076, 58.2%) and the majority of European ancestry (n = 3,174, 97.7%). Only 5.5% (n = 196) of participants were identified as having a pain condition, whilst 21.2% (n = 749) reported significant a sleep problem, and 2.8% (n = 99) reported co-morbid musculoskeletal pain and sleep problems. Adolescents with co-morbid 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.

DISCUSSION: Co-morbid sleep and pain problems were associated with a higher incidence of pain-related and psychological complaints. Sleep problems may therefore be an important modifiable risk factor for alleviating suffering in adolescents with musculoskeletal pain.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.