Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium.
Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium.
Pain. 2024 Nov 1;165(11):2455-2467. doi: 10.1097/j.pain.0000000000003279. Epub 2024 May 28.
Chronic musculoskeletal pain and sleep problems/disorders exhibit a recognized bidirectional relationship; yet, systematic investigations of this claim, particularly in a prospective context, are lacking. This systematic review with meta-analysis aimed to synthesize the literature on the prospective associations between sleep problems/disorders and chronic musculoskeletal pain. A comprehensive search across 6 databases identified prospective longitudinal cohort studies in adults examining the relationship between sleep problems/disorders and chronic musculoskeletal pain. Random-effects meta-analyses, using the Hartung-Knapp adjustment for 95% confidence intervals (CIs), were conducted, and all results were presented as odds ratios (ORs). Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Including 16 articles from 11 study populations (116,746 participants), meta-analyses indicated that sleep problems at baseline may heighten the risk of chronic musculoskeletal pain in both short term (OR 1.64, 95% CI 1.01-2.65) and long term (OR 1.39, 95% CI 1.21-1.59). The evidence for different sleep problem categories was very uncertain. Chronic musculoskeletal pain at baseline may increase the risk of short-term sleep problems (OR 1.56, 95% CI 1.02-2.38), but long-term evidence was very uncertain. The impact of only local or only widespread pain on short-term sleep problems was very uncertain, whereas widespread pain may elevate the risk of long-term sleep problems (OR 2.0, 95% CI 1.81-2.21). In conclusion, this systematic review with meta-analysis suggests that sleep problems are associated with an increased risk of chronic musculoskeletal pain, but the bidirectional nature of this relationship requires further investigation.
慢性肌肉骨骼疼痛和睡眠问题/障碍表现出公认的双向关系；然而，缺乏对此主张的系统调查，特别是在前瞻性背景下。本系统评价和荟萃分析旨在综合关于睡眠问题/障碍与慢性肌肉骨骼疼痛之间前瞻性关联的文献。通过对 6 个数据库的全面搜索，确定了前瞻性纵向队列研究，这些研究在成年人中检查了睡眠问题/障碍与慢性肌肉骨骼疼痛之间的关系。使用 Hartung-Knapp 调整进行随机效应荟萃分析，置信区间为 95%（CI），并以优势比（OR）呈现所有结果。使用推荐评估、制定和评估方法评估证据的确定性。纳入了来自 11 个研究人群的 16 篇文章（116746 名参与者），荟萃分析表明，基线时的睡眠问题可能会增加短期（OR 1.64，95%CI 1.01-2.65）和长期（OR 1.39，95%CI 1.21-1.59）慢性肌肉骨骼疼痛的风险。不同睡眠问题类别的证据非常不确定。基线时的慢性肌肉骨骼疼痛可能会增加短期睡眠问题的风险（OR 1.56，95%CI 1.02-2.38），但长期证据非常不确定。局部或广泛疼痛对短期睡眠问题的影响非常不确定，而广泛疼痛可能会增加长期睡眠问题的风险（OR 2.0，95%CI 1.81-2.21）。总之，本系统评价和荟萃分析表明，睡眠问题与慢性肌肉骨骼疼痛的风险增加有关，但这种双向关系的性质需要进一步研究。
