LAUSR

Pain and inadequate sleep duration are prevalent among adults in the United States. Both pain and inadequate sleep have been related to poorer quality of life and adverse health outcomes. However, the relationships of pain frequency and severity, modeled as predictors, to sleep duration have rarely been studied at the population level, particularly in the U.S. We aimed to investigate the relationships of both pain frequency and pain severity to sleep duration in a representative, population-based U.S. sample. 2018 National Health Interview Survey data were analyzed. Self-reported sleep duration (on average) was categorized as short (6 hours or less), normal (7-9 hours), and long (10+ hours). Self-reported pain frequency (in the last three months) and pain severity (most recent event) were each categorized as “higher” and “lower or no”. Potential confounders/adjustment variables examined included age, sex, weight, chronic health conditions, race/ethnicity, depression, anxiety, and sleep medication use. For adjusted analyses, a multinomial logistic regression was fitted using stepwise selection using a sample of 10,173 U.S. adults. We estimated odds ratios (OR) and 95 percent (%) confidence intervals (CI) for three categories of sleep duration with regard to both pain frequency and severity in an adjusted multinomial model. In a multinomial model adjusted for age, anxiety, depression, and race/ethnicity, higher pain frequency, versus lower/no, was found to be associated with increased odds of short (OR=1.52, 95% CI, 1.38-1.66) and long (OR=1.85, 95% CI, 1.50-2.28) sleep duration versus normal sleep. In the same adjusted model, higher pain severity, versus lower/none, was found to be associated with an increased odds of short (OR=1.49, 95% CI, 1.33-1.68) and long (OR=1.77, 95% CI, 1.40-2.22) sleep duration versus normal sleep duration. Higher pain frequency and higher pain severity, versus low or none, were both associated with an increased odds of insufficient (by 1.5-fold) and excessive (by 1.9 and 1.8-fold, respectively) sleep duration (vs. normal) in a large population-based U.S. sample. Results suggest that the prevention of pain, both its frequency and severity, should be considered to improve unhealthy sleep duration among US adults. None