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The interplay between sleeplessness and high-sensitivity C-reactive protein on risk of chronic musculoskeletal pain. Longitudinal data from the Tromsø Study.

STUDY OBJECTIVES
To examine independent associations of sleeplessness and high-sensitivity C-reactive protein (hsCRP) with risk of chronic musculoskeletal pain, and to explore the joint effect of sleeplessness and hsCRP on risk of chronic musculoskeletal pain.


METHODS
A population-based prospective study of 3,214 women and 3,142 men (mean age 55.4, range 32-87) without severe chronic musculoskeletal pain and with hsCRP ≤10 mg/L at baseline in 2007-2008. Modified Poisson regression was used to calculate adjusted risk ratios (RRs) with 95% confidence intervals (CIs) for any chronic musculoskeletal pain and chronic widespread pain (CWP) at follow-up in 2015-2016 associated with self-reported sleeplessness and hsCRP at baseline.


RESULTS
Compared to persons without sleeplessness, women and men reporting often/or always sleeplessness had RRs of CWP of 2.53 (95% CI 1.94-3.29) and 2.48 (95% CI 1.63-3.77), respectively. There was no clear association between hsCRP and risk of any chronic musculoskeletal pain or CWP. Joint effect analyses using persons without sleeplessness and with a hsCRP <1.00 mg/L as the reference gave RRs for chronic musculoskeletal pain of 1.73 (95% CI 1.26-2.37) for those with often/always sleeplessness and hsCRP <1.00 mg/L; 1.01 (95% CI 0.78-1.32) for those without sleeplessness and hsCRP ≥3.00 mg/L; and 2.47 (95% CI 1.79-3.40) if they had both often/always sleeplessness and hsCRP ≥3.00 mg/L. The corresponding RRs for CWP were 1.89 (95% CI 1.27-2.83), 0.96 (95% CI 0.68-1.37) and 2.83 (95% CI 1.1.91-4.20), respectively.


CONCLUSION
These results suggest that there is an interplay between sleeplessness and hsCRP on risk of any chronic musculoskeletal pain and CWP.