Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland.
Eur J Pain. 2022 May;26(5):1069-1078. doi: 10.1002/ejp.1931. Epub 2022 Mar 18.
It has been suggested that chronotype, the individual preference for 24-h circadian rhythms, influences health. Sleep problems and mental distress are amongst the greatest risk factors for musculoskeletal (MS) pain. The aims of this study were first, to explore the associations between chronotypes and MS pain, with special reference to disabling MS pain and second, to test whether mental distress and insomnia have a modifying role in the associations between chronotypes and MS pain.
The dataset of 4961 individuals was composed of Northern Finns surveyed on MS pain, chronotypes and confounding factors (sex, insomnia, sleep duration, smoking, mental distress, occupational status, education level and number of coexisting diseases) at 46 years. The relationships between chronotypes (evening [E], intermediate [I] and morning [M]) and MS pain were evaluated using multinomial logistic regression. To address the second aim, we included an interaction term (chronotypemental distress, chronotypeinsomnia) in the logistic model.
Compared to the M-types, both the E- and I-types had increased odds of suffering 'disabling pain' in the unadjusted model (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.37-2.33; OR 1.54, 95% CI 1.29-1.84, respectively). However, the association remained statistically significant only after adjusting for all covariates amongst the I-types (OR 1.39, 95% CI 1.15-1.67). Neither mental distress nor insomnia was found to modify the chronotype-MS pain association.
The results highlight the importance of chronotypes for individuals' MS health but suggest the presence of confounding factors in the interplay between these factors.
This study shows that evening and intermediate chronotypes are associated with disabling MS pain, but that mental distress, insomnia and coexisting diseases also play a role in these associations.
个体对 24 小时昼夜节律的偏好，即时型，被认为会影响健康。睡眠问题和精神困扰是肌肉骨骼（MS）疼痛的最大风险因素之一。本研究的目的首先是探讨时型与 MS 疼痛之间的关联，特别关注致残性 MS 疼痛，其次是检验精神困扰和失眠是否在时型与 MS 疼痛之间的关联中具有调节作用。
该数据集由 4961 名在 46 岁时接受过 MS 疼痛、时型和混杂因素（性别、失眠、睡眠持续时间、吸烟、精神困扰、职业状况、教育水平和并存疾病数量）调查的芬兰北部居民组成。使用多项逻辑回归评估时型（晚型[E]、中间型[I]和早型[M]）与 MS 疼痛之间的关系。为了解决第二个目标，我们在逻辑模型中纳入了一个交互项（时型精神困扰，时型失眠）。
与 M 型相比，E 型和 I 型在未调整模型中患“致残性疼痛”的几率均增加（比值比[OR] 1.79，95%置信区间[CI] 1.37-2.33；OR 1.54，95% CI 1.29-1.84）。然而，只有在调整了 I 型的所有混杂因素后，这种关联才具有统计学意义（OR 1.39，95% CI 1.15-1.67）。精神困扰和失眠均未被发现会调节时型与 MS 疼痛的关联。
研究结果强调了时型对个体 MS 健康的重要性，但提示在这些因素之间的相互作用中存在混杂因素。
本研究表明，晚型和中间型时型与致残性 MS 疼痛相关，但精神困扰、失眠和并存疾病也在这些关联中发挥作用。
