Abstract
Adults with sleep problems are at higher risk for onset of musculoskeletal pain, but the evidence is less clear for children. This prospective cohort study investigated whether children with sleep problems are at higher risk for onset of musculoskeletal pain and explored whether sex is a modifier of this association. In a prospective cohort study of Australian schoolchildren (n = 1239, mean age 9 years), the associations between sleep problems at baseline and new onset of both musculoskeletal pain and persistent musculoskeletal pain (pain lasting > 3 months) 1 year later were investigated using logistic regression. The potential modifying effect of sex was also assessed. One-year incidence proportion for musculoskeletal pain onset is 43% and 7% for persistent musculoskeletal pain. Sleep problems were associated with musculoskeletal pain onset and persistent musculoskeletal pain onset in boys, odds ratio 2.80 (95% CI 1.39, 5.62) and OR 3.70 (1.30, 10.54), respectively, but not girls OR 0.58 (0.28, 1.19) and OR 1.43 (0.41, 4.95), respectively.Conclusions: Rates of musculoskeletal pain are high in children. Boys with sleep problems are at greater risk of onset of musculoskeletal pain, but girls do not appear to have higher risk. Consideration of sleep health may help prevent persistent musculoskeletal pain in children.What is Known:• Sleep problems are associated with the onset of musculoskeletal pain in adults.• It is not clear if the association between sleep problems and the onset of musculoskeletal pain is present also in children and if sex plays a role in this association.What is New:• This is the first large population-based study that has prospectively investigated the relationship between sleep problems and onset of musculoskeletal pain in school-aged children.• Children, especially boys with sleep problems, were at increased risk for the development of persistent musculoskeletal pain.
Highlights
MethodsMusculoskeletal pain is a major concern worldwide, with conditions such as low back pain and neck pain ranking highly in years lived with disability (YLDs) in those aged 10 to 19 years old [1]
Sleep problems are associated with the onset of musculoskeletal pain in adults
It is not clear if the association between sleep problems and the onset of musculoskeletal pain is present in children and if sex plays a role in this association
Summary
Musculoskeletal pain is a major concern worldwide, with conditions such as low back pain and neck pain ranking highly in years lived with disability (YLDs) in those aged 10 to 19 years old [1]. One potential risk factor is the presence of sleep problems, with prospective studies in adults suggesting a link between poor sleep and the onset of musculoskeletal pain [6]. Other factors may affect the relationship between sleep and musculoskeletal pain, including levels of physical activity [14, 15] and the presence of psychological symptoms [8, 16,17,18]. Children with psychological symptoms such as attention deficit hyperactivity disorder (ADHD) might experience specific types of sleep problems such as the restless legs syndrome [19]. Restless legs syndrome can occur together with growing pain or without, in which case children with restless legs syndrome might still report symptoms that are misdiagnosed for growing pains [20], showing the complexity of the relationship between sleep and pain
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