Quality of sleep and musculoskeletal pain in adolescents: observational study

Batista, Jéssica Fernanda de Oliveira Lima; Alencar, Thais Costa de; Tolêdo, Janaína Maria Gomes Fonsêca; Mota, Kelly Rodrigues; Santos Júnior, Valdeci Elias dos; Heimer, Mônica Vilela

doi:10.5935/2595-0118.20220010

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ORIGINAL ARTICLE • BrJP 5 (1) • Jan-Mar 2022 • https://doi.org/10.5935/2595-0118.20220010 copy

Quality of sleep and musculoskeletal pain in adolescents: observational study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Musculoskeletal pain (MSP) is related to psychogenic factors and quality of sleep, showing that this triad is a biopsychosocial process. The aim of this study was to analyze an association between poor sleep quality and MSP in adolescents.

METHODS:

This study has an observational, cross-sectional character, in which 545 adolescents, aged between 11 and 15 years, were analyzed. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), the presence of MSP using the Nordic Musculoskeletal Questionnaire (NMQ), temporomandibular disorder using the Axis II of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and excessive daytime sleepiness using the Epworth Sleepiness Scale (ESS). Pearson Chi-square or Fishers Exact test were used to assess the association between two categorical variables.

RESULTS:

The prevalence of poor sleep quality, sleep disorders, MSP and excessive daytime sleepiness were, respectively, 66.8, 9.5, 87.5 and 30.5%. An association was observed between the quality of sleep and the number of hours of sleep per night [OR = 1.49; (1.01 to 2.21)], and between sleep disorders and MSP in the upper back [OR=1.9; (1.0 to 3.3)], and the wrists and hands [OR=2.8; (1.4 to 5.7)]. However, there was no association between sleep quality and MSP [OR=1.29; (0.76 to 2.17)].

CONCLUSION:

An association was found between sleep disorders and MSP, as well as between the number of hours slept per night and quality of sleep.

Keywords:
Adolescent; Musculoskeletal pain; Sleep wake disorders

Variables	n	%
Total	545	100.00
Quality of sleep
Good	181	33.2
Poor	312	57.2
Sleep disorder	52	9.5
Classifcation of sleep
Good	181	33.2
Poor	364	66.8
Degree of excessive daytime sleepiness
Normal	348	63.9
Excessive daytime sleepiness	172	31.6
Severe sleepiness	25	4.6
Excessive daytime sleepiness
Yes	197	36.1
No	348	63.9
Hours of sleep
Less than 8 hours	179	32.8
More or equal to 8	366	67.2
Coughing or heavy snoring
None in the past month	384	70.5
Less than 1 time/week	85	15.6
From 1 to 2 times/week	48	8.8
3 or more times/week	28	5.1
Pain (Q1+ Q4 + Q3 Axis)
Yes	477	87.5
No	68	12.5

Variables	Quality of sleep
	Poor		Good		Total		p-value	OR (CI 95%)
	n	%	n	%	n	%	p-value	OR (CI 95%)
Hours of sleep							p (¹) = 0.043^* *Significant association at 5%. (1) Chi-square test; Q1 = Have you had any problems (such as pain, tingling/numbness) in the past 12 months? Q4 = In the past 7 days, did you have any problems in the? Q3 Axis = Have you had pain in your face, jaw, temple, front ear or ear in the past month?
Less than 8 hours	130	72.6	49	27.4	179	100.0		1.49 (1.01 to 2.21)
More or equal to 8	234	63.9	132	36.1	366	100.0		1.00
Coughing or heavy snoring							p (¹) = 0.939
None in the past month	256	66.7	128	33.3	384	100.0		1.00
Less than 1 time/week	56	65.9	29	34.1	85	100.0		0.97 (0.59 to 1.59)
From 1 to 2 times/week	52	68.4	24	31.6	76	100.0		1.08 (0.64 to 1.84)
Excessive daytime sleepiness							p (¹) = 0.979
Yes	111	66.9	55	33.1	166	100.0		1.00 (0.68 to 1.48)
No	253	66.8	126	33.2	379	100.0		1.00
Pain (Q1 + Q4 + Q3 Axis)							p (¹) = 0.347
Yes	322	67.5	155	32.5	477	100.0		1.29 (0.76 to 2.17)
No	42	61.8	26	38.2	68	100.0		1.00

Variables	Sleep disorder
	Yes		No		Total		p-value	OR (CI 95%)
	n	%	n	%	n	%	p-value	OR (CI 95%)
Neck							p (¹) = 0.896
Yes	15	9.8	138	90.2	153	100.0		1.0 (0.6 to 2.0)
No	37	9.4	355	90.6	392	100.0		1.0
Shoulders							p (¹) = 0.804
Yes	10	8.9	102	91.1	112	100.0		1.0
No	42	9.7	391	90.3	433	100.0		1.1 (0.5 to 2.3)
Upper back							p (¹) = 0.038^* * significant association at 5%; (1) Chi-square test; (2) Fisher’s Exact test.
Yes	21	13.7	132	86.3	153	100.0		1.9 (1.0 to 3.3)
No	31	7.9	361	92.1	392	100.0		1.0
Elbows							p (²) = 1.000
Yes	4	9.5	38	90.5	42	100.0		1.0 (0.3 to 2.9)
No	48	9.5	455	90.5	503	100.0		1.0
Wrists and hands							p (¹) = 0.004^* * significant association at 5%; (1) Chi-square test; (2) Fisher’s Exact test.
Yes	10	4.9	196	95.1	206	100.0		1.0
No	42	12.4	297	87.6	339	100.0		2.8 (1.4 to 5.7)
Lower back							p (¹) = 0.118
Yes	16	13.2	105	86.8	121	100.0		1.6 (0.9 to 3.1)
No	36	8.5	388	91.5	424	100.0		1.0
Hip/thighs							p (¹) = 0.865
Yes	12	9.2	119	90.8	131	100.0		1.0
No	40	9.7	374	90.3	414	100.0		1.1 (0.5 to 2.1)
Knees							p (¹) = 0.517
Yes	16	10.9	131	89.1	147	100.0		1.2 (0.7 to 2.3)
No	36	9.0	362	91.0	398	100.0		1.0
Ankles/feet							p (¹) = 0.459
Yes	20	8.5	216	91.5	236	100.0		1.0
No	32	10.4	277	89.6	309	100.0		1.3 (0.7 to 2.2)
Facial pain							p (¹) = 0.482
Yes	15	8.3	166	91.7	181	100.0		1.0
No	37	10.2	327	89.8	364	100.0		1.3 (0.7 to 2.4)

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[1] Correspondence to: Kelly Rodrigues Mota E-mail: kellyrmota@outlook.com