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. 2014 Aug 1;9(8):e103591.
doi: 10.1371/journal.pone.0103591. eCollection 2014.

Increased insomnia symptoms predict the onset of back pain among employed adults

Maayan Agmon  1 , Galit Armon  2
Affiliations

Increased insomnia symptoms predict the onset of back pain among employed adults

Maayan Agmon et al. PLoS One. .

Abstract

Background: Back pain is among the most prevalent pain disorders causing chronic disability among adults, and insomnia is a common co-morbidity. However, whether insomnia precedes back pain or vice versa remains unclear. The current study tested the temporal association between insomnia and back pain.

Methods: A longitudinal design was used to investigate whether changes in insomnia over time predict the onset of back pain and vice versa. The study was conducted on a cohort of active healthy working adults (N = 2,131, 34% women) at three time points (T1, T2, and T3) over a period of 3.7 years (range = 2.2-5.12) years. Logistic regression analysis was used to test whether increased insomnia symptoms from T1 to T2 predicted the onset of new back pain. Ordinary least squares regression was used to test whether the existence of back pain at T2 predicted an increase in insomnia from T2 to T3.

Results: The results indicated that after controlling for socioeconomic variables, self-reported health, lifestyle behaviors, and anthropometrics, a T1-T2 increase in insomnia symptoms was associated with a 1.40-fold increased risk of back pain at T3 (OR = 1.40; 95% CI = 1.10-1.71). No support was found for reverse causation; i.e., that back pain predicts subsequent increase in insomnia.

Conclusions: Insomnia appears to be a risk factor in the development of back pain in healthy individuals. However, no evidence of reverse causation was found.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Participants Flow: Back pain predicts insomnia.
Figure 2
Figure 2. Participants Flow: Insomnia predicts back pain.
Figure 3
Figure 3. The relationship between insomnia at T2 (after controlling for insomnia at T1) and the log odds of having back pain.
See this image and copyright information in PMC

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