ARE SLEEP DISTURBANCES A RISK FACTOR FOR NECK AND LOW BACK PAIN? A LONGITUDINAL STUDY IN ADOLESCENTS

Introduction: Only few studies have investigated the role of sleep disturbances in adolescents’ musculoskeletal pains. Methods: A two-year follow-up by postal questionnaires was made for the Northern Finland Birth Cohort 1986 at the ages of 16 and 18 years (n=1773). The outcome measures were six-month period prevalences of self-reported neck pain (NP) and low back pain (LBP) (“Reporting Pain” and “Consultation for Pain”). Sleep disturbances were categorised into three groups (major, minor and no sleep disturbances) based on average hours spent sleeping, and whether or not the subject suffered from nightmares, tiredness and sleeping problems. The odds ratios (OR) and 95% confidence intervals (CI) for were obtained from logistic regression and adjusted for all previously suggested risk factors. Results: Sleep disturbances at 16 years predicted NP and LBP at the age of 18. Among the adolescents initially without LBP, major sleep disturbances at 16 predicted LBP at 18 in both girls (OR 2.6; 95% CI 1.2 to 5.5) and boys (2.7; 1.1 to 6.7). Similarly, among those initially without NP, major sleep disturbances at 16 years predicted NP at 18 years in girls (3.9; 1.6 to 9.4) but not in boys. Discussion: Sleep disturbances were an independent risk factor for LBP and NP in adolescence. Possible mechanisms may include decreased time for muscle relaxation during disturbed sleep, co-morbidity with psychological distress, or activation of inflammatory mediators. Perhaps some musculoskeletal pains could be prevented – at least partially – by ensuring that adolescents have sufficient quality and quantity of sleep.