About half of older men experience sleep problems, back pain, or both, according to Soomi Lee, an associate professor of human development and family studies at Penn State. In a recent study, Lee and her colleagues set out to determine whether one of these common problems tends to come before the other. Their findings suggest that back pain can predict the development of sleep problems several years later in men aged 65 and older.
“Back pain and sleep disturbances are both serious concerns for older adults,” Lee explained. “By analysing data collected over a long period, we wanted to understand whether poor sleep leads to back pain, or whether back pain leads to poor sleep. What we found was that back pain tends to come first.”
The study, published in Innovation and Aging, drew on data from the Osteoporotic Fractures in Men Study, which followed 1,055 older men over several years. Participants completed two in-depth clinical sleep assessments at least six years apart. Between these visits, they regularly reported their back pain by mail every four months, rating both how often the pain occurred and how severe it was.
Sleep problems were defined broadly and included irregular sleep patterns, short sleep duration, daytime sleepiness, and dissatisfaction with sleep quality. For each participant, the researchers summarised back pain reports over one year to create overall scores for pain frequency and severity. These scores were then compared with sleep problem scores from the clinical visits.
The researchers first examined whether early sleep problems were linked to later back pain. They then reversed the analysis to see whether earlier back pain predicted sleep issues measured six years later. This second approach revealed a clear pattern: back pain was associated with a 12% to 25% increase in sleep problems years down the line. In contrast, sleep problems did not appear to increase the risk of developing back pain in the future.
Men who reported back pain were more likely to fall asleep either too early or too late and were more dissatisfied with the quality of their sleep overall. According to Lee, this has important implications for families, caregivers, and clinicians. “If loved ones notice back pain in an older adult, it can serve as a warning sign,” she said. “Acknowledging and addressing back pain early may help prevent later sleep problems and the additional health issues linked to poor sleep.”
These associated health concerns include memory difficulties, depression, anxiety, and an increased risk of falls. Lee emphasised that the study focused only on men and that further research is needed to determine whether the same patterns hold for women and for people of colour, who were underrepresented in the sample. Even so, she stressed that anyone experiencing persistent back pain should discuss appropriate management options with a healthcare professional.
“Now that we know back pain tends to precede sleep problems, it’s clearer that effective pain management may play an important role in maintaining good sleep and protecting overall health in older adults over time,” Lee said.
More information: Soomi Lee et al, Back pain precedes sleep problems in older men, Innovation in Aging. DOI: 10.1093/geroni/igaf113
Journal information: Innovation in Aging Provided by Penn State
