SynthesisThe Clinical journal of pain2019
Sleep and Pain: A Systematic Review of Studies of Mediation.
Synthesis in The Clinical journal of pain, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
86 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Effects of pharmacological and non-pharmacological interventions for the management of sleep problems in people with fibromyalgia: a multi-methods evidence synthesis.Health technology assessment (Winchester, England) · 2025Pooled it
- Aquatic therapy improves self-reported sleep quality in fibromyalgia patients: a systematic review and meta-analysis.Sleep & breathing = Schlaf & Atmung · 2024Pooled it
- Efficacy and Safety of Preoperative Melatonin for Women Undergoing Cesarean Section: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.Medicina (Kaunas, Lithuania) · 2023Pooled it
- Efficacy of combined strategies of physical activity, diet and sleep disorders as treatment in patients with chronic shoulder pain. A systematic review.Frontiers in physiology · 2023Pooled it
- Mediators of socioeconomic inequalities in preterm birth: a systematic review.BMC public health · 2022Pooled it
- Effect of intravenous lidocaine on postoperative fatigue syndrome in patients undergoing laparoscopic radical colorectal cancer surgery: a randomized clinical trial.Scientific reports · 2025Trial
- Pain in your day? Get sleep treatment anyway! The role of pain in insomnia treatment efficacy in women veterans.Journal of sleep research · 2024Trial
- Lengthening sleep reduces pain in childhood arthritis: a crossover randomised controlled trial.RMD open · 2023Trial
- Chronic joint pain drives sex-specific changes in hippocampal glutamatergic signaling and sleep.npj biomedical innovations · 2026Article
- Bidirectional associations between daily sleep and pain severity in adults with rheumatoid arthritis: A daily diary and actigraphy study.The journal of pain · 2026Article
- Mediators of the Pain-Depression Relationship in Adults with Chronic Pain: A Systematic Review and Exploratory Meta-Analyses.Journal of clinical medicine · 2026Review
- The Mediating Role of Pain Catastrophizing in Functioning and Mental Health for Youth With Pain-predominant Disorders of Gut-Brain Interaction.Journal of clinical gastroenterology · 2026Article
- Examining Barriers and Facilitators to Physical Activity Among a Diverse Cohort of MSM Living with HIV.AIDS and behavior · 2026Article
- Facilitators and Barriers to Integrating Sleep Recommendations for Counselling Patients With Arthritis: A Survey of Physiotherapists and Students in Canada.Physiotherapy Canada. Physiotherapie Canada · 2026Article
- The association between sleep trajectories throughout pregnancy and postpartum pain in individuals with overweight or obesity: A prospective cohort study.Journal of psychosomatic research · 2026Article
- Psychological distress predicts disease activity in inflammatory bowel disease: Results from the mind-body IBD longitudinal study.Brain, behavior, & immunity - health · 2026Article
- To advance sleep science, let's study change.Sleep · 2026Article
- Associations between pain reactivity to worse sleep and health outcomes.The journals of gerontology. Series B, Psychological sciences and social sciences · 2026Article
- Reframing Chronicity in Research and Care: A Patient-Informed Framework of Pain Adaptation.Journal of pain research · 2026Article
- Exploring predictors of analgesic response in adult women regularly using NSAIDs: insights from a machine learning approach.Frontiers in pain research (Lausanne, Switzerland) · 2026Article
26 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectivesA relationship between sleep and pain is well established. A better understanding of the mechanisms that link sleep and pain intensity is urgently needed to optimize pain management interventions. The objective of this systematic review was to identify, synthesize, and critically appraise studies that have investigated putative mediators on the path between sleep and pain intensity.
methodsA systematic search of 5 electronic bibliographic databases (EMBASE, MEDLINE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials) was conducted. Eligible studies had to apply a formal test of mediation to variables on the path between a sleep variable and pain intensity or vice versa. All searches, data extraction and quality assessment were conducted by at least 2 independent reviewers.
resultsThe search yielded 2839 unique articles, 9 of which were eligible. Of 13 mediation analyses, 11 investigated pathways from a sleep variable to pain intensity. Putative mediators included affect/mood, depression and/or anxiety, attention to pain, pain helplessness, stress, fatigue, and physical activity. Two analyses investigated pathways from pain intensity to a sleep variable, examining the potentially mediating role of depressive symptoms and mood. Although evidence supported a mediating role for psychological and physiological aspects of emotional experiences and attentional processes, methodological limitations were common, including use of cross-sectional data and minimal adjustment for potential confounders. DISCUSSION: A growing body of research is applying mediation analysis to elucidate mechanistic pathways between sleep and pain intensity. Currently sparse evidence would be illuminated by more intensively collected longitudinal data and improvements in analysis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.