1-03 The role of sleep problems in the development of musculoskeletal pain in children

The role of sleep problems in the development of musculoskeletal pain in children

Alessandro Andreucci1, Paul Campbell1, Lisa Mundy2, Susan Sawyer2, Silja Kosola2, George Patton2, Kate M Dunn1

1) United Kingdom 2) Australia

Background and aims

Adults with sleep problems are at higher risk for musculoskeletal pain, but the evidence is less clear for children and adolescents. This may be due to potential effect modifiers, which have biological and behavioural plausibility (e.g. gender, screen time use). This study aims to investigate the association between sleep problems and musculoskeletal pain in a prospective cohort study of children, including specific assessment of potential effect modification.


Australian schoolchildren (n=1239, mean age 8.9 years) were recruited and followed-up 1-year later. Associations between self-reported frequency of sleep problems (“often” or “almost always”) at baseline, and the onset of both musculoskeletal pain and persistent musculoskeletal pain (pain that lasted > 3 months) at 1-year, were investigated using logistic regression. The potential modifying effects of gender and screen time were assessed by stratification.


At baseline, 386 had no musculoskeletal pain and 928 did not have persistent musculoskeletal pain. At follow-up, 45.3% of children (175/386) developed musculoskeletal pain, and 11.2% (104/928) developed persistent musculoskeletal pain. Children with sleep problems were not at significantly higher risk of developing musculoskeletal pain compared to those without sleep problems (adjusted odds ratio (OR) 1.3; 95% confidence interval 0.77, 2.16). However, stratified analysis revealed that boys with sleep problems were at increased risk (adjusted OR 2.8; 1.31, 5.81). For the onset of persistent musculoskeletal pain, sleep problems were a significant risk factor (adjusted OR 2.3; 1.53, 3.58); stratification indicated increased risk in those with high screen time (> 2 hours/day; adjusted OR 2.6; 1.56, 4.44).


These data highlight potential groups of children at increased risk for musculoskeletal pain onset (i.e. boys with sleep problems) and persistent musculoskeletal pain (i.e. children with sleep problems, particularly with high levels of screen time). Further research is needed to confirm these associations and explore potential casual mechanisms.

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