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The role of sleep quality on the relationship between posttraumatic stress symptoms and pain in women

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Abstract

Pain frequently co-occurs with elevated posttraumatic stress symptoms (PTSS); women are at elevated risk for their co-occurrence. PTSS and pain are associated with poor sleep quality; yet, little research has examined how sleep impacts their co-occurrence. The current study examines the indirect role of sleep on the relationship between PTSS and pain. A community sample of 182 women completed psychometrically-sound questionnaires assessing PTSS, sleep quality, pain characteristics, depression and anxiety symptoms, and anxiety sensitivity. We examined how sleep quality impacted associations among PTSS and pain intensity and pain interference, while controlling for key psychological factors. Greater PTSS was associated with worse pain interference, and poor sleep quality had a significant indirect effect on this relationship. Sleep may represent a modifiable behavioral mechanism that contributes to the mutual maintenance of PTSS and pain in women. Future research is needed to further clarify the role of sleep quality in their co-occurrence.

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Acknowledgements

We thank Caitlin Murrary for her assistance in the revision of this manuscript.

Funding

Rachel Aaron is supported by T32GM086270 awarded to Tonya Palermo; Tonya Palermo is supported by K24HD060068; Melanie Noel is supported by the Vi Riddell Pain Initiative of the Alberta Children’s Hospital Research Institute. This research was supported by a Hearst Grant awarded to Melanie Noel by the Center for Child Health, Behavior and Development at the Seattle Children’s Hospital Research Institute.

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  1. Rachel Aaron

    Present address: Johns Hopkins Medicine, 1800 Orleans St., Baltimore, MD, 21287, USA

Authors and Affiliations

  1. Seattle Children’s Research Institute, University of Washington, Seattle, USA

    Rachel Aaron, Joanne Dudeney & Tonya Palermo

  2. Alberta Children’s Hospital and Research Institute, University of Calgary, Calgary, Canada

    Melanie Noel

  3. Oregon Health & Science University, Portland, USA

    Anna Wilson & Amy Holley

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Correspondence to Rachel Aaron.

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Rachel Aaron, Melanie Noel, Joanne Dudeney, Anna Wilson, Amy Holley, and Tonya Palermo declare that they have no conflict of interest.

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All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Aaron, R., Noel, M., Dudeney, J. et al. The role of sleep quality on the relationship between posttraumatic stress symptoms and pain in women. J Behav Med 42, 924–933 (2019). https://doi.org/10.1007/s10865-019-00016-5

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