Frequent chronic pain in relation to sleep disturbances: A nationally representative study of adults in the United States.

Authors

Philip M Zendels, Symielle A Gaston, Michael V Vitiello, Christopher Payne, W Braxton Jackson, Sara Nowakowski, Chandra L Jackson

Published in

Sleep medicine. Volume 149. Pages 109291. Sep 25, 2026. Epub Sep 25, 2026.

Abstract

Frequent chronic pain (FCP) is associated with sleep. Primarily, pain can increase stress and inflammation, impairing sleep. In turn, but less commonly, poor sleep can increase pain sensitivity, suggesting potential bidirectionality. However, the FCP-sleep relationship has not been investigated across various sociodemographic groups, especially in nationally representative samples.
Using the 2013-2018 US National Health Interview Survey, we investigated FCP-sleep associations among adults. Participants self-reported musculoskeletal pain over the past three months (FCP: yes ['everyday'/'most days'] vs. no ['some days'/'never']), short sleep duration (<7-h), insomnia symptoms (difficulty falling/staying asleep ≥3 times/week), and nonrestorative sleep (NRS: waking feeling rested ≤3 days/week). Adjusting for confounders, we used survey-weighted Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for associations, overall and by age, sex, and race along with ethnicity.
Among 90,810 adults, mean age±SE was 48 ± 0.11 years, 24% reported FCP (64% of adults aged ≥50 years, 56% of women). FCP was associated with a higher prevalence of short sleep, with stronger associations among younger (PR_{18-30 years} = 1.57[1.44-1.70]) vs. older adults (PR _{≥ 50 years} = 1.34[1.29-1.39]). FCP was associated with a higher prevalence of insomnia symptoms, especially among men (PR_men = 1.82[1.75-1.89] vs. PR_women = 1.57[1.52-1.61]) and Hispanic/Latine (PR = 1.84[1.70-1.99]) and Black (PR = 1.79[1.66-1.92]) vs. White adults (PR = 1.63[1.58-1.67]). FCP was associated with a higher prevalence of NRS (PR = 1.66[1.62-1.69]), with stronger associations among older adults (PR _{≥ 50 years} = 1.73[1.67-1.79] vs. PR_{18-30 years} = 1.61[1.52-1.70] and PR_31-49years = 1.48[1.43-1.53]) and men (PR_men = 1.75[1.69-1.82] vs. PR_women = 1.59[1.55-1.63]).
There were complex associations between FCP and sleep health among US adults that varied by sociodemographic characteristics. Targeted intervention studies are warranted.

PMID:
42868772
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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