Abstract
Chronic pain, sleep problems, and psychological distress (PD) can be disabling conditions and previous research has shown that they are associated. The nuances of the comorbid nature of these conditions may be important to understand for those who treat these conditions. This study examined the bidirectional associations of these health factors concurrently and over time in a sample of U.S. adults (N = 1,008, Mage = 57.68) from the Midlife in the United States (MIDUS) study. Participants reported on their daily pain, sleep quantity, and psychological distress over eight days. A modified Random Intercept Cross-lagged Panel Model was used to analyze the relations, starting with the whole sample and then a comparison of those with and without chronic pain. Results indicated that nightly variation in sleep quantity predicted next day psychological distress for both groups. Sleep quantity also predicted next-day pain, but only for individuals with chronic pain. Associations between pain and psychological distress were found both at the daily level and individual (between-person) level. This between-person association was stronger for those with chronic pain. The lagged associations between sleep, and both pain and psychological distress for the chronic pain group indicate that, increased quantity of sleep predicts decreased next-day pain and psychological distress. Providers could consider this unidirectional lagged relationship when prioritizing treatment for patients with these comorbid conditions. Future research may examine whether responsive, just-in-time treatments might intervene after participants wake from a poor night’s sleep to counteract the negative effects of reduced sleep on PD and pain.
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Data Availability
The Midlife in the United States (MIDUS) study data are available at the Inter-university Consortium for Political and Social Research website: https://www.icpsr.umich.edu/web/ICPSR/studies/26841. The R code and model output files are made available at https://osf.io/m65nr/?view_only=c8dc47179a52447d9d68b75d127e311d.
Notes
Headache pain was used by itself as an outcome in supplementary analyses. Of note however, there were not enough participants with chronic headache pain to conduct group comparisons.
As a sensitivity analysis, an alternative way of determining of chronic pain was also modeled. It was based on whether the participant reported a four or greater on any form of pain on a majority of the days in which they responded to the daily diary survey. Values of four to five are often identified as the cutoff between mild and moderate pain (Boonstra et al., 2016; Oldenmenger et al., 2013). This approach recognizes that individuals with chronic pain can have fluctuations in the presence and severity of their pain (Mun et al., 2019). Because the findings from these alternative models were similar to the ones presented in the results below, they are not be discussed further, but the findings are available as supplemental material.
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Austen Anderson: Conceptualization, Methodology, Formal Analysis, Writing- original draft, Writing – review & editing, Visualization. Danielle Holliday: Conceptualization, Writing-original draft, Writing – Reviewing & editing.
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Anderson, A.R., Holliday, D. Mapping the associations of daily pain, sleep, and psychological distress in a U.S. sample. J Behav Med 46, 973–985 (2023). https://doi.org/10.1007/s10865-023-00432-8
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DOI: https://doi.org/10.1007/s10865-023-00432-8