Work

Sleep disturbance and multimorbidity: a cross-sectional and longitudinal study in the knee pain and related health in the community cohort

Year: 2025

Type: article

Abstract: Study Objectives To examine whether there is a temporal association between sleep disturbance and multimorbidity. Methods We performed a cross-sectional and longitudinal observational analysis in people aged 40 years or more, recruited from the knee pain and related health in the community cohort study. The primary exposure was the Sleep Problems Index II score in tertiles measured at baseline. The primary outcome was count of chronic conditions developed in 5 years. Pain, low mood, and anxiety were measured at 2 years as mediators. Poisson regression was used to calculate adjusted relative risk and 95% confidence intervals. Results We included 4488 participants in the cross-sectional analysis at baseline and 1941 in the 5-year longitudinal analysis. At baseline, the adjusted relative risks for prevalent multimorbidity were 1 (reference) for tertile 1, 1.09 (95% confidence interval; 1.01–1.18) for tertile 2, and 1.21 (95% confidence interval; 1.11–1.32) for tertile 3 of the sleep disturbance score (p for trend <.001). Of the total association between sleep disturbance and multimorbidity, 14 per cent (95% confidence interval; 9% to 19%) were mediated by pain and 7 per cent (95% confidence interval; 2% to 13%) by low mood. In the 5 year follow-up, the adjusted relative risk for incident multimorbidity were 1 (reference) for tertile 1, 1.12 (95% confidence interval; 0.98–1.28) for tertile 2, and 1.25 (95% confidence interval; 1.06–1.47) for tertile 3 (p for trend .007). Of the total association between sleep disturbance and multimorbidity, 10 per cent (95% confidence interval; 2% to 18%) was mediated by pain. Conclusions Sleep disturbance is associated with multimorbidity. The association is dose-dependent, temporal, and partially mediated by pain. Statement of Significance Sleep disturbance has been hypothesized to be a risk factor for the development of multimorbidity. We investigated this association using data from participants aged 40 and over in the knee pain and related health in the community cohort. We found that sleep disturbance is indeed associated with both prevalent and incident multimorbidity. The association is dose-dependent and temporal, and partly mediated by pain.

Source: SLEEP Advances

DOI: 10.1093/sleepadvances/zpaf039