Tuesday, April 1, 2025
4/1/2025
Sleep, Pain, Active Social Life, and Inflammation (SPAI) - Abstract Chronic pain is a prognostic marker of illness and imposes a substantial burden on the healthcare system, affecting approximately 20-30% of US adults. Sleep problems commonly co-occur with chronic pain, yet little is known of how sleep impacts chronic pain. Social engagement and inflammation have relationships with both sleep and chronic pain, but no study has examined these behavioral and biological mechanisms underlying the impact of sleep on chronic pain. This R01 initiates a multi-cohort study to examine the extent to which the impact of sleep on chronic pain is mediated by social lifestyles and inflammation. In this study, we take a sleep health perspective to capture multiple sleep characteristics critical to chronic pain (regularity, satisfaction, alertness, timing, efficiency, and duration). Based on multiple sleep variables captured by self-report, actigraphy, and/or polysomnography, we will identify “sleep health profiles” (the composite number of sleep problems or latent groups with similar sleep characteristics across multiple dimensions) and link them to chronic pain outcomes. Our sleep profile approach has advantages because it can consider multiple sleep problems that may co-occur within individuals, and may differentially impact pain outcomes. Leveraging three NIH-funded projects (Midlife in the United States Study-MIDUS, Outcomes of Sleep Disorders in Older Men-MrOS, and Multicenter Osteoarthritis Study-MOST), we examine multiple common chronic pain conditions prevalent in adult populations (any chronic pain, back pain, and knee pain) and their multiple manifestations (frequency, severity, and sensitization). This can help determine whether the associations between sleep health profiles and chronic pain emerge across different pain conditions. Aim 1 will examine the longitudinal impact of sleep health profiles on subsequent changes in pain for three separate pain outcomes. We hypothesize that poor sleep health profiles are associated with: [MIDUS] new onset of any chronic pain and/or an increase in pain interference among midlife and older adults; [MrOS] new onset of back pain and/or increases in the frequency and severity of back pain among older men; [MOST] increases in knee pain severity and clinical sensitization among older men/women with the risk of osteoarthritis over time. Aim 2 will examine behavioral and biological mechanisms underlying the impact of sleep health profiles on changes in pain. We hypothesize that poor sleep health profiles are associated with more chronic pain over time mediated by lower diversity in social activities (i.e., a less active social life) or by a higher risk of systemic inflammation. Aim 3 will examine independent and joint effects of behavioral and biological mechanisms underlying the impact of sleep health profiles on changes in pain. Our multi-cohort approach also allows us to detect potential social disparities in sleep and chronic pain by aggregating relevant racial and sex sub-groups across cohorts. This project will inform future behavioral interventions (e.g., sleep health intervention) to improve chronic pain in adults by identifying specific sleep characteristics, and key behavioral and biological mechanisms linking sleep health and chronic pain.
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