Sleep characteristics and pain in middle-aged and older adults: Sex-specific impact of physical and sitting activity

Amy N Costa; Adriana Coman; Madison Musich; Jeeeun Park; David Q Beversdorf; Christina S McCrae; Ashley F Curtis

doi:10.1016/j.sleep.2023.09.030

Sleep characteristics and pain in middle-aged and older adults: Sex-specific impact of physical and sitting activity

Sleep Med. 2023 Nov:111:180-190. doi: 10.1016/j.sleep.2023.09.030. Epub 2023 Sep 27.

Authors

Amy N Costa¹, Adriana Coman², Madison Musich³, Jeeeun Park⁴, David Q Beversdorf⁵, Christina S McCrae⁶, Ashley F Curtis⁷

Affiliations

¹ Department of Psychology, University of South Florida, Tampa, FL, USA; Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO, USA.
² Department of Biological Chemistry, Grinnell College, Grinnell, IA, USA.
³ Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO, USA.
⁴ Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO, USA; Department of Biological Sciences, University of Missouri-Columbia, Columbia, MO, USA.
⁵ Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO, USA; Department of Neurology, University of Missouri-Columbia, Columbia, MO, USA; Department of Radiology, University of Missouri-Columbia, Columbia, MO, USA.
⁶ College of Nursing, University of South Florida, Tampa, FL, USA.
⁷ College of Nursing, University of South Florida, Tampa, FL, USA. Electronic address: ashleycurtis@usf.edu.

PMID: 37788556
DOI: 10.1016/j.sleep.2023.09.030

Abstract

Objectives: The relationship between poor sleep health and worse pain is established. Physical activity has been successful in reducing chronic pain and improving sleep in aging adults. Despite known sex differences (more women than men experiencing chronic pain and insomnia), sex-specific patterns of interactive associations between physical activity, sleep, and pain remain unexplored. This study tested whether physical and sitting activity moderated associations between sleep characteristics and pain intensity, and whether sex further moderated these relationships.

Methods: Participants aged 50+ (N = 170, M_age = 64.34, 72 women) completed an online survey measuring pre-sleep arousal (Pre-sleep Arousal Scale), sleep (Pittsburgh Sleep Quality Index), past month average pain intensity, and physical activity (International Physical Activity Questionnaire). Multiple regressions evaluated whether minutes of physical activity (total, vigorous, moderate, walking) or sitting activity, pre-sleep arousal, sleep, sex, or their interaction was associated with pain. Analyses controlled for education, difficulty walking, body mass index, total medical conditions, pain medication, and depressive/anxiety symptoms.

Results: In women, vigorous activity interacted with total pre-sleep arousal and somatic pre-sleep arousal in its association with pain. Higher total arousal and somatic arousal were associated with worse pain intensity only for women who reported highest levels of vigorous activity. No such associations were observed for men or for other physical or sitting activity levels.

Conclusions: Vigorous physical activity may exacerbate the association between more pre-sleep arousal and worse pain in middle-aged and older women. Research should explore potential sex-specific mechanisms (e.g., inflammatory cytokines, arousal neural networks) underlying these results.

Keywords: Arousal; Chronic pain; Gender; Health; Insomnia; Physical activity; Sex; Sitting.

MeSH terms

Aged
Chronic Pain*
Female
Humans
Male
Middle Aged
Sitting Position
Sleep
Sleep Initiation and Maintenance Disorders*
Surveys and Questionnaires