Biopsychosocial markers distinguishing chronic pain patients with and without insomnia symptoms: A machine learning study in the UK Biobank
Year: 2026
Type: preprint
Abstract: Chronic pain is defined as pain persisting beyond three months and affects 10–50% of the global population and is among the leading causes of disability worldwide (Zimmer et al., 2021; Stubhaug et al., 2024). Insomnia symptoms represent one of the most prevalent and clinically significant comorbidities in chronic pain populations, affecting 50–70% of individuals with chronic pain compared to approximately 16% of the general population (Benjafield et al., 2025; Mathias et al., 2018). The impact of both conditions combined gets substantially amplified, manifesting as heightened pain sensitivity, longer pain duration, greater disability, reduced physical activity, and increased rates of depression, anxiety, and suicidal ideation (Husak & Bair, 2019). The interaction has been characterized as bidirectional. Chronic pain can affect sleep quality through pain related arousals, fragmented and non-restorative sleep (Mathias et al., 2018). On the other hand, having short or disturbed sleep is associated to an increase in pain sensitivity (Sivertsen et al., 2015) and a decrease in pain tolerance. In addition, in a study using longitudinal data from the UK Biobank, insomnia was identified as a key risk factor for pain development and increased pain distribution (Tanguay et al., 2023). In the opposite direction, insomnia symptoms as a predictor of pain has also been identified but effects are usually smaller (Arnison et al., 2021; Liu et al., 2021). Suggested shared underlying mechanisms are: an increase in inflammatory markers, HPA axis disregulation, monoaminergic system among others (Haack et al., 2020) and associations with anxiety, depression, percieved stress have been identified (Ravyts et al., 2019; Haidary et al., 2024). However, 30–50% of individuals with chronic pain do not develop insomnia symptoms, implying that chronic pain and their shared mechanisms is insufficient to explain this comorbidity. Given the multifactorial nature of both conditions, a biopsychosocial lens may help clarify which factors drive this distinction. The UK Biobank’s large sample size, comprehensive sleep, psychological and biological data measurements provide an opportunity to characterize the biological, psychological, and social markers of insomnia symptoms within individuals with chronic pain in a unified framework. Therefore, this study aims to identify the biological, psychological, and social markers that distinguish chronic pain populations with and without insomnia symptoms.
Language: English
Topic: Sleep and related disorders
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7170572350