Back pain linked to worse sleep years later in men over 65, according to study

UNIVERSITY PARK, Pa. — About half of older men suffer from sleep problems, back pain or both, according to Soomi Lee, associate professor of human development and family studies at Penn State. Lee recently led a study to investigate whether one precedes the other and found that back problems can predict sleep problems years later in men over 65 years old.

“We know that back pain and sleep are serious issues for older adults,” Lee said. “We studied data collected over several years to understand whether poor sleep could predict back pain or if back pain could predict poor sleep, and we found it was the latter.”

In the study, published in Innovation and Aging, the researchers analyzed data from the Osteoporotic Fractures in Men Study, a study of 1,055 older men who completed two clinical sleep visits six or more years apart and answered questionnaire by mail about back pain — measured by severity and frequency — every four months between the two sleep study visits. Sleep problems were defined by irregular sleep, limited amounts of sleep and self-reports of daytime sleepiness and sleep satisfaction.

For each participant, the researchers compiled back pain reports over the course of one year and used these reports to create back pain frequency and severity scores. They then compared each participant’s sleep problem score from the first sleep-study visit to their back pain score six years later.

They also reversed the approach — comparing participants’ back pain scores from early in the study to their sleep problems score at their second visit six years later — to assess if back pain could predict sleep issues.

Back pain predicted a 12% to 25% increase in an individual’s sleep problems six years later, the researchers said, but sleep problems did not predict future back pain. 

They specifically found that men with back pain fell asleep either too early or too late and were dissatisfied with their sleep quality.

“If caregivers or loved ones see back pain issues, this can be a warning sign,” Lee said.  “Older people should acknowledge their back pain problems so that they can prevent subsequent sleep problems and the other health issues that accompany inadequate sleep, including memory problems, depression, anxiety and falling.”

Lee noted the sample was limited to men, and further research is needed to see if the same result holds in women or in people of color, who were underrepresented in the study sample. Regardless of one’s race or sex, she said those experiencing back pain should discuss the appropriate management — which could include physical therapy or exercise, among others — with their clinician.

“Now that we know that back pain precedes sleep problems, it is clearer that pain management may be necessary for maintaining quality sleep and preventing broader health problems in older adults over time,” Lee said. 

Other contributors include David Almeida, professor of human development and family studies, and Muhammad Thalil, postdoctoral scholar in the Center for Healthy Aging, at Penn State; Brent Small of the University of North Carolina at Chapel Hill; Katie L. Stone, Christina X. Mu and Peggy M. Cawthon of the University of California, San Francisco; Eric Roseen of Boston University Chobanian and Avedisian School of Medicine; David McNaughton of CQUniversity; Cecilie Krage Øverås of the Norwegian University of Science and Technology; Hazel Jenkins of Macquarie University; Casper Nim and James Young of  University of Southern Denmark; and Howard Fink and Kristine Ensrud of the University of Minnesota.

This research was funded by the National Institutes of Health’s National Heart, Lung, and Blood Institute.

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