A nationwide study on pain manifestations and sleep problems in community-dwelling older adults: findings from ELSI-Brazil

Key summary points Aim To investigate the association between self-reported sleep problems and pain manifestations. Findings Older adults with poor sleep quality, initial, intermediate and final insomnia, and daytime sleepiness had greater odds of reporting frequent pain and pain-related disability. Message The results may help in the proposition of programs and public health policies and inform health professionals about the importance of assessing the sleep quality of their patients. Purpose Sleep problems are common and affect approximately 36–70% of older adults worldwide and can be associated with negative outcomes such as pain. There is believed to be a bidirectional relationship between sleep problems and pain, modulated by inflammation and stress. The objective was to investigate the association between self-reported sleep problems and pain manifestations. Methods A cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (2019–2021) was conducted. The exposure variables were self-reported sleep problems: poor sleep quality, insomnia (initial, intermediate, and final), and daytime sleepiness. The outcomes were self-reported pain manifestations: frequent pain, moderate/intense/strong pain, and pain-related disability. Logistic regressions were performed to verify the association between exposures and outcomes. Results A total of 6875 community-dwelling older adults participated in this study (71.1 ± 8.3 years; 54.4% female). Older adults with self-reported poor sleep quality, initial, intermediate and final insomnia, and daytime sleepiness had, respectively, 1.99 (95% CI 1.57–2.53), 1.47 (95% CI 1.11–1.97), 1.65 (95% CI 1.27–2.14), 1.69 (95% CI 1.29–2.22), and 1.76 (95% CI 1.35–2.29) greater odds of reporting frequent pain. The odds of moderate/intense/strong pain were higher in older adults that reported poor sleep quality (OR: 2.21; 95% CI 1.08–4.51). Older adults with self-reported poor sleep quality, initial, intermediate and final insomnia, and daytime sleepiness had, respectively, 1.84 (95% CI 1.11–3.02), 1.73 (95% CI 1.14–2.62), 1.80 (95% CI 1.19–2.73), 1.58 (95% CI 1.07–2.34), and 1.63 (95% CI 1.11–2.39) greater odds of reporting pain-related disability. Conclusion Self-reported sleep problems are associated with pain manifestations in older adults. The results may help in the proposition of programs and public health policies.