ArticleInternational journal of epidemiology2025
Mediating impact of sleep quality and duration on the relationship between socio-economic conditions and pain.
Article in International journal of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSleep-related problems exhibit strong social patterning and are associated with pain; however, their mediating role in socio-economic inequities in pain remains largely unknown. We aim to assess the extent to which life course socio-economic inequities in pain experience and severity are mediated through sleep quality and duration.
methodsWe used data from 1719 individuals [52.0% women; mean age 60.1 years (SD 9.1)] from the Swiss CoLaus|PsyCoLaus study, with both sleep measures at baseline (2009-2012) and pain measures at follow-up (2014-2017). Life course socio-economic conditions were assessed by using the father's and individual's occupational position, educational level, and income. Potential mediators included self-reported sleep quality (measured by using the Pittsburgh Sleep Quality Index, ranging from 0 to 21, with high scores indicating poorer sleep quality) and duration (short <6 h/night; normal 6-8.5 h/night; long >8.5 h/night). Presence of pain, chronic pain, and pain severity were assessed by using a self-administered questionnaire. We estimated age, sex, and country of birth with adjusted β coefficient, odds ratio, and proportion mediated by using counterfactual mediation analyses.
resultsPain and chronic pain were reported by 47% and 40.8% of the participants, respectively. Among 699 participants with reported pain severity data, the mean pain severity score was 3.6 (SD 1.7) (scale ranging from 0 = no to 10 = worst imaginable pain). Sleep quality explained 30% of the educational, 21% of the occupational, and 45% of the income inequities in pain; 20% of the occupation and 51% of the income inequities in chronic pain; and 15%, 9%, and 16% of the father's occupation, educational, and income inequities in pain severity, respectively. Short sleep duration explained 31% of the education inequities in pain and 37% of the education and income inequities in chronic pain.
conclusionThis study suggests poor sleep quality and short sleep duration partially mediate socio-economic inequities in pain. The role of other potential mediators at individual and societal levels should be further investigated.
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