Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland.
Pain. 2022 Nov 1;163(11):2154-2161. doi: 10.1097/j.pain.0000000000002609. Epub 2022 Feb 7.
People with an evening (E)-type preference (ie, chronotype) experience musculoskeletal (MSK) pain and reduced health-related quality of life (HRQoL) more often than morning (M) types. Musculoskeletal pain is a well-established contributor to reduced HRQoL. This study aimed to evaluate whether eveningness amplifies the association between MSK pain and HRQoL in contrast to morningness. Questionnaire data on MSK pain dimensions (intensity, disability at work, number of pain sites [NPSs], and frequency), chronotype, covariates (sex, sufficiency of sleep duration, mental distress, and presence of coexisting diseases), and HRQoL (measured by 15D) were collected among 46-year-old individuals belonging to the Northern Finland Birth Cohort 1966 (N = 4257). Individuals without any MSK pain were excluded. General linear models were conducted to estimate the associations between chronotypes, MSK pain dimensions, and HRQoL. The interaction terms (chronotype × pain dimension) were tested in the models. There were 13% E-types and 43% M-types in the study sample. Each pain dimension and chronotype were related to HRQoL. In the sex-adjusted chronotype-specific models, the reduction in HRQoL in relation to pain appeared to be stronger among E-types than among M-types in respect to all pain dimensions. After adjustments, this was particularly seen in terms of NPS and pain frequency. Our findings suggest that eveningness intensifies the association between MSK pain and HRQoL, and, thus, they are indicative of E-types being more sensitive than M-types to the consequences of MSK pain. As such, MSK pain treatment and rehabilitation actions to improve HRQoL should be especially targeted at E-types.
具有夜间（E）型偏好（即，昼夜类型）的人比早晨（M）型的人更容易出现肌肉骨骼（MSK）疼痛和降低健康相关生活质量（HRQoL）。肌肉骨骼疼痛是降低 HRQoL 的一个公认的因素。本研究旨在评估与早晨型相比，夜间型是否会放大 MSK 疼痛与 HRQoL 之间的关联。在属于芬兰北部出生队列 1966 年（N=4257）的 46 岁个体中，收集了关于 MSK 疼痛维度（强度、工作障碍、疼痛部位数量[NPS]和频率）、昼夜类型、协变量（性别、睡眠时长充足性、精神困扰和共存疾病的存在）和 HRQoL（通过 15D 测量）的问卷数据。排除了没有任何 MSK 疼痛的个体。进行了一般线性模型来估计昼夜类型、MSK 疼痛维度和 HRQoL 之间的关联。在模型中测试了交互项（昼夜类型×疼痛维度）。研究样本中有 13%的 E 型和 43%的 M 型。每个疼痛维度和昼夜类型都与 HRQoL 相关。在性别调整后的特定昼夜类型模型中，与疼痛相关的 HRQoL 下降在 E 型中似乎比在 M 型中更为明显，这与所有疼痛维度有关。经过调整，在 NPS 和疼痛频率方面尤其如此。我们的发现表明，夜间型会加剧 MSK 疼痛与 HRQoL 之间的关联，因此，E 型比 M 型对 MSK 疼痛的后果更为敏感。因此，改善 HRQoL 的 MSK 疼痛治疗和康复措施应特别针对 E 型。
