Pain Management Strategies Research Articles

Individualizing musical tempo to spontaneous rates maximizes music-induced hypoalgesia.

Music has long been recognized as a noninvasive and cost-effective means of reducing pain. However, the selection of music for pain relief often relies on intuition rather than on a scientific understanding of the impact of basic musical attributes on pain perception. This study examines how a fundamental element of music-tempo-affects its pain-relieving properties. One important finding in research on temporal dynamics of music is that people tend to sing or tap at a characteristic rate when asked to produce a simple melody. This characteristic rate, known as the spontaneous production rate (SPR), is consistent across different rhythm production tasks and may reflect the output of an endogenous oscillator. According to dynamical systems theory, SPRs represent optimal efficiency, minimizing energy expenditure while maximizing behavioral accuracy. This study examined whether aligning music tempo with individual SPRs could enhance the hypoalgesic effects of music. First, participants' SPRs were measured by asking them to produce a familiar melody at a comfortable rate. Next, they were asked to rate painful thermal stimulations under 4 conditions: music modified to match participants' SPR, music modified to be 15% faster or 15% slower than participants' SPR, and silence. Results revealed that musical tempos matching participants' SPR produced stronger reductions in pain compared to faster or slower tempo conditions, supporting the hypothesis that musical tempo aligned with individual rates is optimal for reducing pain. These findings underscore the individual-specific effects of musical tempo on pain perception, offering implications for personalized pain management strategies.

Ultrasound-Guided Maxillary Nerve Block in Nasal Surgery.

Emphasis on enhanced recovery after surgery (ERAS) protocols and opioid use reduction have led to a growing interest in alternative pain management strategies. This study describes and evaluates the ultrasound-guided suprazygomatic maxillary (SZM) nerve blocks for patients undergoing functional and cosmetic nasal surgery as an adjunct to postoperative pain management. A retrospective, multicenter analysis was conducted on patients who underwent functional nasal surgery and rhinoplasty and evaluated the impact of SZM blocks on intraoperative anesthetic and opioid use, postoperative pain scores recorded in the PACU, and PACU length. A total of 64 patients met inclusion criteria. Twenty-five patients received a SZM block prior to undergoing the procedure while the remaining patients underwent standard local anesthetic use. SZM blocks significantly reduced the amount of intraoperative pain medication used (p = 0.02), including hydromorphone (p=0.007), when compared to a traditional approach to local anesthetic use. SZM blocks also significantly reduced post-anesthesia PACU stay at one institution (p=0.016). SZM nerve blocks are a simple and effective way to deliver local anesthetic and are associated with decreased intraoperative opioid use and PACU stay.

Understanding the dynamics of post-surgical recovery and its predictors in resource-limited settings: a prospective cohort study

IntroductionPost-surgical recovery time is influenced by various factors, including patient demographics, surgical details, pre-existing conditions, post-operative care, and socioeconomic status. Understanding these dynamics is crucial for improving patient outcomes. This study aims to identify significant predictors of post-surgical recovery time in a resource-limited Ethiopian hospital setting and to evaluate the variability attributable to individual patient differences and surgical team variations.MethodsA linear mixed model was employed to analyze data from 490 patients who underwent various surgical procedures. The analysis considered multiple predictors, including age, gender, BMI, type and duration of surgery, comorbidities (diabetes and hypertension), ASA scores, postoperative complications, pain management strategies, physiotherapy, smoking status, alcohol consumption, and socioeconomic status. Random effects were included to account for variability at the patient and surgical team levels.ResultsSignificant predictors of prolonged recovery time included higher BMI, longer surgery duration, the presence of diabetes and hypertension, higher ASA scores, and major post-operative complications. Opioid pain management was associated with increased recovery time, while inpatient physiotherapy reduced recovery duration. Socioeconomic status also significantly influenced recovery time. The model fit statistics indicated a robust model, with the unstructured covariance structure providing the best fit.ConclusionThe findings highlight the importance of individualized patient care and the effective management of modifiable factors such as BMI, surgery duration, and postoperative complications. Socioeconomic status emerged as a novel factor warranting further investigation. This study underscores the value of considering patient and surgical team variability in post-surgical recovery analysis, and calls for future research to explore additional predictors and alternative modeling techniques to enhance our understanding of the recovery process.

Treatment outcomes and quality of life among patients with chronic pain in a referral hospital in Ethiopia

Background: Chronic pain is a pervasive and complex public health issue that profoundly impacts the quality of life (QoL), mental health, and daily activities. Defined as pain lasting beyond three to six months, it arises from diverse causes, including injuries, medical conditions, and psychological factors. Patients with chronic pain often experience poor QoL. In Ethiopia, the burden is compounded by limited healthcare infrastructure, socioeconomic challenges, and cultural attitudes toward pain management. This study aimed to assess treatment outcomes and QoL among patients with chronic pain attending the Tikur Anbessa Specialized Hospital (TASH) neurology clinic. Methods: A cross-sectional study was conducted at TASH, using the SF-12 questionnaire to assess QoL through patient interviews and clinical data collected from medical records. All patients meeting inclusion criteria and attending the clinic for chronic pain management between March and May 2023 were included. Results: Of the 200 patients included, 64.5% were female, and chronic low back pain was the most common diagnosis (33.5%). Amitriptyline, prescribed for 39.5% of participants, was the most frequently used medication. Despite treatment, 59.5% of patients reported uncontrolled pain, adversely affecting their physical and emotional well-being. Conclusions: Although treatment led to some improvement, the majority of patients continued to experience uncontrolled pain, significantly impairing their QoL. These findings underscore the urgent need for enhanced pain management strategies in Ethiopia.

Advanced Pain Management in Patients with Terminal Cancer.

Understanding and managing pain in patients with terminal cancer is a vital aspect of palliative care, aimed at relieving suffering and improving quality of life in the final stages of illness. Studies indicate that approximately 50% of patients with stage 4 cancer report moderate to severe pain, with a quarter experiencing severe cancer-related pain. Despite opioid prescriptions in 97% of cases, a significant portion of patients continues to suffer unresolved pain during the last week of life. Cancer-related pain is multifaceted, often involving nociceptive, neuropathic, and mixed elements, necessitating a thorough, multidimensional approach to both assessment and treatment. The challenge of opioid tolerance and the potential for addiction demands careful monitoring. Interventional therapies, including nerve blocks and spinal cord stimulation, are gaining attention as valuable complements or alternatives to opioid use. Additionally, alternative methods like yoga, special diets, and food supplements provide diverse options for managing pain. Psychological therapies, including cognitive-behavioral techniques and mindfulness, address the mental and emotional dimensions of pain. Emerging technologies, including artificial intelligence, hold promise for optimizing pain management in terminal cancer care. This review explores advanced pain management strategies, focusing on traditional opioid therapies, modern pharmaceutical innovations, and non-pharmacological approaches such as alternative medicine, massage, dietary interventions, and psychological therapy.

Qualitative analysis of pain impact in adult patients with X-linked hypophosphatemia

Abstract We previously reported pain as a predominant finding in adult patients with XLH. This study explored health-related quality-of-life using the 36-item Short Form survey instrument (SF-36v1) and pain experiences of adults with X-linked hypophosphatemia (XLH) through qualitative analysis of interviews with 15 patients (11 females, 4 males). Age-adjusted differences using SF-36 were lower than the general population in all domains of health-related quality of life, with significant differences notably related to physical function and pain. Ten themes emerged from semi-structured interviews: 1) Chronic and Variable Pain: Patients reported persistent pain of varying intensity and location; 2) Impact on Mobility and Daily Life: Pain severely restricted daily activities, affecting lifestyle, employment, and independence; 3) Pain Management: Patients used medications, physical therapy, lifestyle changes, alternative therapies, and assistive devices; 4) Healthcare and Accessibility Challenges: Access to appropriate care and treatments was limited by insurance issues and healthcare providers’ lack of XLH knowledge; 5) Emotional and Psychological Impact: Chronic pain and limitations led to social isolation, depression, and emotional burden; 6) Desire for Improved Information and Support: Patients sought better information, treatment, and community support; 7) Challenges with Physical Inactivity: Staying active was essential but difficult, as inactivity worsened pain; 8) Navigating Healthcare Services: Accessing therapy and insurance was often challenging; 9) Long-term Outlook and Concerns: Patients worried about disease progression and future health; and 10) Advocacy and Awareness: Increased public and medical awareness was needed to improve care. Although pain is not a universal experience within this population, it is a significant issue for many individuals with XLH. These data illustrate the profound impact of XLH on multiple life aspects underscoring the need for effective pain management strategies, better healthcare accessibility, supportive tools, and a more knowledgeable medical community to improve quality of life. Insights from this study will guide the development of a digital pain self-management intervention tailored to XLH patients to address these needs.

Barriers and new opportunities in developing effective therapies for diabetic neuropathy: International expert consensus recommendations.

Diabetic neuropathy (DN) affects up to half of individuals with type 1 and type 2 diabetes. Despite evidence that improving metabolic and cardiovascular health can slow its progression, DN remains a significant clinical challenge due to the lack of disease-modifying therapies and effective pain management strategies. This consensus aimed to identify gaps and recommend strategies to address these challenges. A workshop, initiated by Steno Diabetes Centre Copenhagen and the Danish Diabetes and Endocrinology Academy, conducted a gap analysis based on insights from clinical studies, observational cohorts, and clinical practice. Online invitations targeted experienced clinicians, researchers, and drug developers committed to improving DN treatment through innovative clinical trials. Thirty-five participants from six countries reached consensus via a Delphi process on key steps to advance DN therapy. Four critical barriers and needs were addressed: (1) Translating bench research to clinical practice, (2) Enhancing clinical trial design, (3) Improving outcome measures, and (4) Identifying effective treatments for painful DN. Successful interventional trials require robust outcome measures to capture clinically meaningful changes in DN phenotypes, providing the basis for developing effective, disease-modifying treatments.

Novel pain management strategy for uterine fibroid embolization

BackgroundUterine fibroid embolization can be associated with significant pain due to fibroid ischemia and interventions of the procedure itself. Fentanyl and midazolam are commonly provided for sedation and pain relief, but are not tolerated by all patients. This report outlines a novel pain management strategy for uterine fibroid embolization in a patient who could not receive either opioids or benzodiazepines.MethodsA 51 year old woman presenting with menorrhagia due to uterine fibroids was referred to interventional radiology for embolization. She was allergic to most opiates and had previously become agitated with IV midazolam, resulting in termination of a previous attempt at embolization. Thus, a combination of three analgesic modalities was used: intraarterial ropivacaine in the uterine arteries, superior hypogastric nerve block with ropivacaine, and intravenous acetaminophen. The patient underwent successful embolization and reported only intermittent pain of 1–2 out of 10 intensity.DiscussionThis combined analgesic cocktail represents a novel alternative to traditional sedation for uterine fibroid embolization and may serve as a viable option for patients with similar contraindications.

Exploring Pain and Opioid Misuse Among Patients With Sickle Cell Anemia: Associations With Health Literacy and Pain Catastrophizing.

This study aimed to investigate pain characteristics, opioid misuse prevalence, and the relationship between healthliteracy and pain catastrophising in patients with Sickle Cell Disease (SCD). This was a cross-sectional study. Data were collected from patients with SCD in Oman. Validated tools were used to assess pain (Brief Pain Inventory), healthliteracy (HLS-Q12), opioid misuse (Current Opioid Misuse Measure [COMM]), and pain catastrophising (Pain Catastrophising Scale). The study included 169 patients with SCD, with an average age of 34.4 (SD = 12.9) years, of whom 51.5% werefemale. A total of 79.3% of the participants reported experiencing pain, with an average total pain score of 3.8 (SD = 2.6).Additionally, 74% of the patients were identified as being at risk of opioid misuse. The risk of opioid misuse was positivelyassociated with pain catastrophising (r = 0.302, p < 0.001) and negatively associated with health literacy (r = -0.220, p = 0.005). Pain severity and interference are also linked to the risk of opioid misuse. Sociodemographic factors, such as age, sex, and education, showed no significant association with the risk of opioid misuse. Patients with SCD face high rates of chronic pain and considerable risk of opioid misuse. Psychological factors, particularly pain catastrophising and lower healthliteracy, were strongly associated with misuse risk, while sociodemographic factors had less impact. These findings highlight the need for targeted interventions addressing psychological support and health literacy to reduce opioidmisuse in SCD patients. Healthcare providers should integrate pain management strategies with educational programs to enhancehealth literacy and mitigate the psychological burden of pain.

A randomized controlled trial comparing immersive virtual reality games versus nitrous oxide for pain reduction in common outpatient procedures in pediatric surgery

BackgroundChildren often experience anxiety and pain during minor surgical procedures, prompting the search for effective pain management strategies beyond traditional pharmaceutical approaches. This study aims to evaluate the efficacy of virtual reality (VR) as a pain reduction method in pediatric outpatient surgical interventions compared to the standard use of nitrous oxide. The research questions explore pain reduction levels, patient preferences, enjoyment during VR use, and the time limit of the VR application.MethodsThe study employs a randomized controlled trial design, utilizing VR technology and nitrous oxide in separate groups in 100 children at the age from 6 to 15 undergoing minor surgical procedures. Outcomes are monitored directly after the intervention and two weeks following the procedure. The primary outcome measure is the pain level, assessed using visual face and visual analog scales. Secondary outcomes are the fun and/or fear experienced during the intervention, the willingness to undergo the same procedure again (if necessary), and whether there is a time limit with the VR application compared to nitrous oxide. The study also considers adverse events and safety measures.DiscussionThe study aims to address a significant research gap in pediatric pain management strategies, as it is the first randomized controlled trial designed to compare pain levels using VR versus a control group with nitrous oxide analgosedation in children undergoing minor surgical procedures. Preliminary evidence suggests VR may offer a viable alternative to traditional pain management methods, as VR technology could be an effective distraction and pain management tool for pediatric patients undergoing outpatient surgical procedures.Trial registrationClinicalTrials.gov NCT05510141. Registered on August 22, 2022. Virtual Reality Games in Pediatric Surgery—Full Text View—ClinicalTrials.gov.Trial sponsorThe principal investigator, Cordula Scherer act as the Sponsor, Clinic for pediatric surgery, Inselspital, Bern University Hospital, CH 3010 Bern, Switzerland.

Metabolite-Sensing Receptors: Emerging Targets for Modulating Chronic Pain Pathways.

Chronic pain is a debilitating condition affecting millions worldwide, often resulting from complex interactions between the nervous and immune systems. Recent advances highlight the critical role of metabolite-sensing G protein-coupled receptors (GPCRs) in various chronic pain types. These receptors link metabolic changes with cellular responses, influencing inflammatory and degenerative processes. Receptors such as free fatty acid receptor 1 (FFAR1/GPR40), free fatty acid receptor 4 (FFAR4/GPR120), free fatty acid receptor 2 (FFAR2/GPR43), and Takeda G protein-coupled receptor 5 (TGR5/GPR131/GPBAR1) are key modulators of nociceptive signaling. GPR40, activated by long-chain fatty acids, exhibits strong anti-inflammatory effects by reducing cytokine expression. Butyrate-activated GPR43 inhibits inflammatory mediators like nitric oxide synthase-2 and cyclooxygenase-2, mitigating inflammation. TGR5, activated by bile acids, regulates inflammation and cellular senescence through pathways like NF-κB and p38. These receptors are promising therapeutic targets in chronic pain, addressing the metabolic and inflammatory factors underlying nociceptive sensitization and tissue degeneration. This review explores the molecular mechanisms of metabolite-sensing receptors in chronic pain, their therapeutic potential, and challenges in clinical application. By uncovering these mechanisms, metabolite-sensing receptors could lead to safer, more effective pain management strategies.

Analgesic Overdose in Patients With Dental Pain. A Cross-Sectional Study in Two Dental Emergency Clinics.

Dental pain is common, and many patients use analgesics to alleviate the pain. Analgesics are readily accessible, and overdosing may lead to severe complications. This study explores the extent of analgesic overdosing in patients with dental pain. Data were collected from two dental emergency clinics in Copenhagen, Denmark, via questionnaires and interviews with 180 patients. Results showed that 82.8% (n = 149) had taken at least one type of analgesic, and 9% (n = 15) had exceeded the recommended maximum dosage. Of all patients with dental pain, 75.6% (n = 136) used paracetamol, 54.4% (n = 98) ibuprofen, 10% (n = 18) opioids, and 11.1% (n = 20) other types of analgesics. Most frequently, the pain was of pulpal origin (n = 119; 66.1%). Of all analgesics used, most were obtained places where guidance should be available, for example, pharmacies, dental clinics or hospitals (n = 152; 54%). The patients were aware of the recommended maximum daily dosage for paracetamol and ibuprofen in 39% (n = 70) and 41% (n = 73) of the cases, respectively. In conclusion, most patients with dental pain use analgesics to alleviate their pain. A substantial proportion of these patients overdose themselves, potentially putting them at risk of severe systemic complications. This study highlights the need for better patient education and safer pain management strategies.

Pain Management in Pediatrics: What the IR has to Offer.

Pediatric pain management presents unique challenges due to the intrinsic characteristics of children such as their developmental stages, communication barriers, and varying pain perceptions. Life-limiting conditions affecting children are a growing medical concern, requiring a comprehensive, multidisciplinary approach to improve quality of life or ensure a dignified end of life. Interventional radiology (IR) plays a critical role in this strategy, similar to its role in adult care. Not only life-limiting conditions pose a challenge in pediatric chronic pain management, but also other benign chronic diseases (e.g., cystic fibrosis, muscular dystrophy, neurodegenerative disorders, metabolic disorders). This review focuses on specific IR strategies for pediatric pain management, including ablation, embolization/chemoembolization, and nerve blocks. It emphasizes the importance of tailored approaches for pediatric patients, considering genetic disorders and oncological diseases, which may require a diverse range of IR treatments. The aim is to provide a summary of these interventional techniques and highlight the unique considerations necessary for effective pediatric pain management.

ENHANCING SPINAL ANESTHESIA WITH DEXMEDETOMIDINE: A PROSPECTIVE STUDY ON PROLONGING ANALGESIA AND REDUCING OPIOID REQUIREMENTS IN INFRA UMBILICAL SURGERIES

Objective: Pain management in surgical settings poses significant challenges, particularly in minimizing opioid use due to associated risks. Dexmedetomidine, a selective α2-adrenergic agonist, has shown promise as an adjunct in spinal anesthesia to enhance analgesic and anesthetic effects. Methods: This prospective, randomized, double-blind study involved 60 patients undergoing infraumbilical surgeries, divided into two groups. Group D received intravenous dexmedetomidine, while Group C received a saline placebo. We assessed the duration of sensory and motor blocks, sedation levels, and the time to first postoperative analgesia request. Results: Group D exhibited significantly longer durations of sensory and motor blocks, higher sedation scores, and extended time before requesting postoperative analgesia compared to Group C. These results suggest improved anesthetic quality and pain control with dexmedetomidine. Conclusion: Intravenous dexmedetomidine enhances spinal anesthesia by prolonging block durations and improving sedation, potentially decreasing the need for postoperative opioids. This supports its use as an effective adjunct in anesthesia, contributing to safer, more effective pain management strategies.

Opioid prescribing patterns following surgical interventions for benign prostatic hyperplasia

Introduction: This study aimed to analyze opioid prescribing behavior following surgical interventions for benign prostatic hyperplasia (BPH), focusing on differences in postoperative opioid prescribing practices between patients who undergo surgical procedures in operative room (OR) settings vs. non-operative room (non-OR) settings. Methods: A retrospective cohort study was conducted using a 10% random sample of the IQVIA PharMetrics® Plus for Academics database, including men who underwent surgical interventions for BPH from 2015–2020. Propensity score analysis and inverse probability treatment weighting were employed to adjust for potential confounders. Primary outcomes included opioid receipt, cumulative days of opioid use, and morphine equivalent daily dose (MEDD). Results: Among the included men (n=6022), those undergoing procedures in OR settings were more likely to receive opioid prescriptions postoperatively compared to those in non-OR settings (42.78% vs. 28.00%, p&lt;0.001). While cumulative days and MEDD of opioid prescriptions did not significantly differ between groups, there was a statistically significant difference in the distribution of opioid receipt duration (p=0.0128). The adjusted model showed significantly higher odds of opioid prescription for men undergoing OR procedures (odds ratio 1.922, 95% confidence interval 1.690–2.185). Conclusions: Men undergoing BPH surgeries in OR settings were more likely to receive opioid prescriptions postoperatively, suggesting potential overprescription. Despite similar cumulative opioid use, differences in prescription rates indicate a need for improved postoperative pain management strategies, possibly using non-opioid alternatives. Future research should focus on optimizing pain control, characterizing actual opioid consumption, and considering patient-specific factors in surgical decision-making.

Marine-derived bioactive compounds for neuropathic pain: pharmacology and therapeutic potential.

Neuropathic pain, a challenging condition often associated with diabetes, trauma, or chemotherapy, impairs patients' quality of life. Current treatments often provide inconsistent relief and notable adverse effects, highlighting the urgent need for safer and more effective alternatives. This review investigates marine-derived bioactive compounds as potential novel therapies for neuropathic pain management. Marine organisms, including fungi, algae, cone snails, sponges, soft corals, tunicates, and fish, produce a diverse range of secondary metabolites with significant pharmacological properties. These include peptides (e.g., conopeptides, piscidin 1), non-peptides (e.g., guanidinium toxins, astaxanthin, docosahexaenoic acid, fucoidan, apigenin, fumagillin, aaptamine, flexibilide, excavatolide B, capnellenes, austrasulfones, lemnalol), and crude extracts (e.g., Spirulina platensis, Dunaliella salina, Cliothosa aurivilli). These compounds exhibit diverse mechanisms of action, such as modulating ion channels (e.g., transient receptor potential channels, voltage-gated sodium, calcium, and potassium channels, and G protein-coupled inwardly rectifying potassium channels), interacting with cell-surface receptors (e.g., nicotinic acetylcholine, NMDA, kainate, GABAB​, and neurotensin receptors), inhibiting norepinephrine transporters, reducing oxidative stress, and attenuating neuroinflammation. These effects collectively contribute to alleviating nerve degeneration and symptoms of neuropathic pain, including hyperalgesia, allodynia, and associated psychomotor disturbances. Marine-derived bioactive compounds represent promising alternatives to conventional neuropathic pain treatments, to advance their development and assess their integration into neuropathic pain management strategies.

Neonatal Pain Management: Is There An Endocrinal Response?

Neonates exhibit pain responses characterized by various endocrinal changes, including alterations in cortisone and oxytocin serum levels, as well as physiological and emotional reactions. The administration of neonatal pain management leads to the normalization of endocrine hormones, including cortisone and oxytocin, which are affected by the presence of neonatal pain. Diagnosing neonatal pain is complex; however, effective management is essential. An adequate balance should be established between the analgesics used for pain management and their associated side effects. Uncontrolled neonatal pain is correlated with delayed development with increased neurologic insult. This review aims to examine the significance of neonatal pain, along with its clinical and physical manifestations. It also explores strategies for managing neonatal pain, encompassing both pharmacological and non-pharmacological methods, along with the particular medications utilized in pharmacological interventions. This discussion includes various non-pharmacological methods for managing neonatal pain. Additionally, this review examines methods for pain assessment. The aim is to highlight the significance of pain in this vulnerable population and to promote the implementation of diverse management strategies for neonatal pain to prevent serious yet avoidable, adverse effects in neonates.

Cryoneurolysis for Post Operative Pain Following Chest Surgery: Contemporary Evidence and Future Directions.

Management of acute and chronic pain following surgery remains a critical patient management challenge, with poor pain management associated with negative patient satisfaction, increased opioid consumption and a high incidence of adverse events. Chest surgery specifically carries a high incidence of significant early and chronic post operative pain. The high incidence, prolonged duration of pain, and adverse effects associated with chronic opioid analgesia, has given rise to the need for non-opioid pain management strategies. Cryoneurolysis, also known as cryoanalgesia, has emerged as a promising option for both acute and chronic pain management. While cryoneurolysis was first developed over fifty years ago, its utilization was limited by technical implementation challenges and limitations in identifying target structures percutaneously. Advances both in cryoneurolysis delivery devices as well as ultrasound have reinvigorated interest in the technique, with recent studies highlighting the advantages of cryoneurolysis, including its favorable side effect profile, long duration of efficacy and relative technical simplicity. The purpose of this review is to examine techniques for cryoneurolysis, and explore recent evidence for safety and efficacy of the technique following different surgical procedures.

Global estimates of prevalence of chronic painful neuropathy among patients with chemotherapy-induced peripheral neuropathy: systematic review and meta-analysis of data from 28 countries, 2000–24

IntroductionAlthough the prevalence of chemotherapy-induced peripheral neuropathy (CIPN) has been reported, the proportion of patients with CIPN who report chronic painful neuropathy remains poorly understood, despite its significant impact on...

Sleep problems, pain interference, and global subjective health outcome: Findings from a representative aging study in Ghana

We investigated the association between sleep problems and global self-rated health (SRH) in individuals aged ≥50 years in Ghana and explored the sex-wise mediating role of pain interference in this association. Data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study were analyzed (N=1201). Global SRH and pain interference were assessed with the Medical Outcomes Study (Short Form-36) Scale. Sleep-related problems were assessed on a 5-point scale from none=1 to extreme=5. Adjusted OLS regressions and bootstrapped mediation models evaluated the hypothesized associations. The mean (SD) age was 66.1 (11.9) years and 63.3 % were females. Sleep problems were associated with increases in pain interference (β = 0.320, p < 0.001) and poor SRH (β = 0.039, p < 0.001). Pain interference mediated 61.6% of the sleep problems–SRH association in the overall sample (β =0.063, Bootstrap 95%CI=0.014–0.034) and 36.7% among women (β =0.023, Bootstrap 95%CI=0.023–0.053). Effective sleep and pain management strategies may improve subjective health outcomes, particularly among older women.