The joint association of musculoskeletal pain and domains of physical activity with sleep problems: cross-sectional data from the DPhacto study, Denmark

  • Eivind Schjelderup SkarpsnoEmail author
  • Paul Jarle Mork
  • Tom Ivar Lund Nilsen
  • Marie Birk Jørgensen
  • Andreas Holtermann
Original Article



To investigate if occupational physical activity (OPA) and leisure-time physical activity (LTPA) influence the association between musculoskeletal pain and sleep problems.


Cross-sectional study includes 678 workers in the Danish PHysical ACTivity cohort with Objective measurements (DPhacto). Musculoskeletal pain was assessed by questionnaires, while OPA and LTPA were measured with accelerometers for up to 6 consecutive days. We used logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for self-reported insomnia symptoms and non-restorative sleep.


Analyses of the joint association of musculoskeletal pain and OPA showed that workers with high pain and high OPA had ORs of 5.80 (95% CI 2.64–12.67) for insomnia symptoms and 2.50 (95% CI 1.37–4.57) for non-restorative sleep, compared to those with low pain and low OPA, whereas workers with high pain and low OPA had ORs of 4.67 (95% CI 2.17–10.07) for insomnia symptoms, and 2.67 (95% CI 1.46–4.89) for non-restorative sleep, respectively. Furthermore, workers with high pain and high LTPA had ORs of 4.23 (95% CI 2.16–8.32) for insomnia symptoms and 1.95 (95% CI 1.09–3.48) for non-restorative sleep, compared to those with low pain and low LTPA, whereas workers with high pain and low LTPA had ORs of 3.34 (95% CI 1.66–6.70) for insomnia symptoms and 2.14 (95% CI 1.21–3.80) for non-restorative sleep, respectively.


Workers with high musculoskeletal pain who also conducted high levels of OPA or LTPA reported higher prevalence of insomnia symptoms.


Physical work exposure Work demands Accelerometer Technical measurement Insomnia 



The authors would like to thank the DPhacto research group and personnel who contributed to the data collection and analysis, especially Julie Lagersted-Olsen, Dorte Ekner, Klaus Hansen, and Jørgen Skotte.

Author contributions

Study concept and design: all authors. Drafting of the manuscript: ESS. Critical revision of the manuscript: all authors. Statistical analysis: ESS, PJM, TILN, and AH. Analysis and interpretation of data: all authors. Critical revision: all authors. Final approval: all authors.


This work was supported by a grant to Eivind Schjelderup Skarpsno from the Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU). The National Research Centre for the Working Environment (NRCWE), and the Danish Working Environment Research Fund (Reference Number 11-2017-03) financed the data collection of this study.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

The study was approved by the Ethics Committee for the Capital Region of Denmark and conducted in accordance with the Declaration of Helsinki.

Informed consent

All workers who participated in the study signed an informed consent.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Public Health and NursingNorwegian University of Science and Technology (NTNU)TrondheimNorway
  2. 2.Department of Neurology and Clinical NeurophysiologySt. Olavs HospitalTrondheimNorway
  3. 3.Clinic of Anaesthesia and Intensive CareSt. Olavs HospitalTrondheimNorway
  4. 4.Department of Forensic ScienceUniversity of CopenhagenCopenhagenDenmark
  5. 5.National Research Centre for the Working EnvironmentCopenhagenDenmark
  6. 6.Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark

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