About half of older men experience either sleep problems, back pain, or both, according to Soomi Lee, associate professor of human development and family studies at Penn State. A new study led by Lee has found that back pain in men over 65 can predict future sleep problems.
"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."
The study was published in Innovation and Aging. Researchers analyzed information from the Osteoporotic Fractures in Men Study, which involved 1,055 older men who completed two clinical sleep visits at least six years apart. Participants also answered questionnaires about their back pain every four months between the two visits. Back pain was measured by severity and frequency, while sleep problems were defined as irregular sleep patterns, limited amounts of sleep, daytime sleepiness, and dissatisfaction with sleep quality.
Researchers created scores for each participant's back pain frequency and severity over one year. They compared these scores to participants' reports of sleep problems six years later to determine if there was a link between earlier back pain and later sleep issues. The reverse approach was also tested: researchers looked at whether earlier sleep problems predicted later back pain.
Findings showed that having back pain increased the risk of developing future sleep problems by 12% to 25% over six years. However, initial sleep problems did not lead to an increase in future back pain.
Specifically, men with more severe or frequent back pain tended to fall asleep too early or too late and reported lower satisfaction with their overall quality of sleep.
"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 that the study sample included only men and had limited representation from people of color. She suggested further research is needed to see if similar patterns occur among women or other groups. She advised those experiencing back pain to talk with their clinician about possible management strategies such as physical therapy or exercise.
"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.
The research team included contributors from Penn State; University of North Carolina at Chapel Hill; University of California, San Francisco; Boston University Chobanian and Avedisian School of Medicine; CQUniversity; Norwegian University of Science and Technology; Macquarie University; University of Southern Denmark; and University of Minnesota. Funding for this work came from the National Institutes of Health's National Heart, Lung, and Blood Institute.
