Increased mortality in people with chronic multisite pain and insomnia: the HUNT study

Insomnia is common among individuals with chronic musculoskeletal pain, and both conditions have been linked to mortality. However, the joint association of chronic multisite pain and insomnia with all-cause mortality is unknown, which we aimed to investigate in this study.

We used data from 39,545 persons participating in the third wave of the Norwegian HUNT Study (2006-08) with complete information on both musculoskeletal pain and insomnia symptoms, linked to the national Cause of Death Registry. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated to assess the risk of death associated with the joint association of insomnia and chronic multisite pain.

Compared to individuals without chronic musculoskeletal pain and no insomnia, individuals with multisite chronic pain had a HR for all-cause mortality of 1.21 (95 % CI 1.01 to 1.43) if they reported insomnia and a HR of 1.00 (0.91-1.11) if they did not suffer from insomnia. Compared to the same reference category, pain-free individuals with insomnia had a HR of 1.05 (95 % 0.83 to 1.34). Our data showed no evidence of a synergistic effect between chronic multisite pain and insomnia on all-cause mortality.

Individuals with chronic multisite pain and insomnia appeared to have higher all-cause mortality compared to pain-free persons without insomnia. Although speculative, these findings suggest that improving sleep quality in individuals with chronic multisite pain and insomnia may contribute to better overall health and potentially lower the risk of death from all causes.