Pain as a mediator of sleep problems in arthritis and other chronic conditions
Authors: Elizabeth M. Badley, Anthony V. Perruccio, and J. Denise Power
Objective To examine the associations between arthritis and insomnia symptoms and unrefreshing sleep, as well as the role of pain as a mediator of these relationships. Methods Analyses were conducted on the cross-sectional, nationally representative, weighted sample of adults 18 years of age (n = 118,336) in the 2000/2001 Canadian Community Health Survey. Four logistic regression models were estimated for each sleep problem (model 1: arthritis only; model 2: model 1 + sociodemographic characteristics, lifestyle factors, and other chronic conditions; model 3: model 2 + mental health [stress, depression]; and model 4: model 3 + pain). Mediation by pain was quantified by the percentage change in the effect of arthritis on a particular sleep problem by comparing models 3 and 4. Results The prevalence of insomnia symptoms and unrefreshing sleep in persons with arthritis was 24.8% and 11.9%, respectively. These estimates are twice as high as those for persons without arthritis. In multivariate regression analyses, the addition of pain decreased the effect of arthritis by 53% (insomnia symptoms) and 64% (unrefreshing sleep). The effect of arthritis was still statistically significant in these models, suggesting that pain is a partial mediator of these relationships. Conclusion Insomnia symptoms and unrefreshing sleep affect a considerable proportion of individuals with arthritis. Pain mediates a substantial amount of the relationship between arthritis and sleep problems. Better pain management could significantly improve sleep in individuals with arthritis.
Please note that abstracts only appear in the language of the publication and might not have a translation.
Mayilee Canizares and Elizabeth M. Badley (2012).
Comparison of health-related outcomes for arthritis, chronic joint symptoms, and sporadic joint symptoms: A population-based study
Arthritis Care and Research , 1708-1714
Orit Schieir, Sheilah Hogg-Johnson, Richard H. Glazier, and Elizabeth M. Badley (2016).
Sex variations in the effects of arthritis and activity limitation on first heart disease event occurrence in the Canadian general population: Results from the Longitudinal National Population Health Survey
Arthritis Care and Research , 811-818
Jacek A. Kopec, Eric C. Sayre, Philippe Fines, William M. Flanagan, Claude Nadeau, Anya Okhmatovskaia, Michael C. Wolfson, David Buckeridge, Saeideh Dahaghin, Sam Harper, Allison Heath, Deirdre Hennessy, Richard Liu, Doug Manuel, Jillian Oderkirk, Mushfiqur Rahman, Behnam Sharif, Brendan Smith, and Meltem Tuna (2015).
Effects of reductions in body mass index on future osteoarthritis burden in Canada: A population-based microsimulation study
Arthritis Care and Research , 1098-1105
Elizabeth M. Badley, Margot Shields, Siobhan O'Donnell, Wendy E. Hovdestad, and Lil Tonmyr (2019).
Childhood maltreatment as a risk factor for arthritis: Findings from a population-based survey of Canadian adults
Arthritis Care and Research , 1366-1371
Anthony V. Perruccio, J. Denise Power, and Elizabeth M. Badley (2005).
Arthritis onset and worsening self-rated health: The role of pain and activity limitations
Arthritis Care and Research , 571-577
Elizabeth M. Badley, Mayilee Canizares, and Anthony V. Perruccio (2017).
A population-based study of changes in arthritis prevalence and arthritis risk factors over time: Generational differences and the role of obesity
Arthritis Care and Research , 1818-1825
Dimitri Bollegala, Anthony V. Perruccio, and Elizabeth M. Badley (2011).
Combined impact of concomitant arthritis and back problems on health status: Results from a nationally representative health survey
Arthritis Care and Research , 1584-1591