Associations between pain reactivity to worse sleep and health outcomes

Sleep and pain are co-occurring issues in adulthood. "Pain reactivity to worse sleep" refers to person-specific changes in daily pain following nights of shorter-than-usual sleep duration or poorer-than-usual sleep quality. We examined the cross-sectional and longitudinal relationships between sleep-related pain reactivity with psychological distress and the number of chronic conditions.

Data were obtained from the Work, Family, and Health Study, which collected data from workers (n = 311; Mage = 41.38 years), who completed eight days of daily diary. We controlled for sociodemographic and health covariates in a series of multilevel structural equation models and growth curve models in Mplus. Sensitivity analyses adjusted for sleep and pain medications and stratified analyses by age.

Those with higher pain severity reactivity to shorter sleep duration (B = 0.54, p < .001) and higher pain severity reactivity to poorer sleep quality (B = 0.58, p < .001) had more concurrent distress. In the growth curve models, pain reactivity to worse sleep was not associated with a change in distress or the number of chronic conditions. After controlling for sleep and pain medication use, higher pain reactivity to poorer sleep quality was associated with more concurrent distress, and contrary to hypotheses, higher pain location reactivity to poorer sleep quality was associated with a decrease in distress and fewer chronic conditions over time.

Higher pain reactivity to worse sleep was associated with more concurrent distress but not distress over time or risk of chronic conditions. Future directions are to examine the influence of pain reactivity to worse sleep in larger and more diverse samples across longer follow-up.