Risk of sleep problems in middle-aged and older adults experiencing bodily pains : Serial multiple mediation estimates of emotion distress and activity limitations

Razak M. GYASI*, Emelia AIKINS, Gift DUMEDAH, Nelson GYASI-BOADU, Prince Boakye FRIMPONG, Mary Sefa BOAMPONG, Daniel BUOR, Simon MARIWAH, Francis NAAB, David R. PHILLIPS

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

Abstract

Objectives

Pain is increasingly becoming common among middle-aged and older adults. While research on the association between pain characteristics and sleep problems (SP) is limited in low- and middle-income countries, the underlying mechanisms of the association are poorly understood. This study examines the association of bodily pain intensity and pain interference with SP and investigates the mediating role of activity limitation and emotional distress in this association.

Methods

We analyzed population-based data, including 1,201 individuals aged ≥50 (mean [SD] age 66.14 [11.85] years) from the 2016–2018 AgeHeaPsyWel-HeaSeeB study in Ghana. Multiple OLS regressions and serial multiple mediation modeling using bootstrapping analyses examined direct and indirect effects from pain to SP through activity limitation and emotional distress.

Results

Regressions demonstrated that pain intensity and interference were significantly associated with higher levels of activity limitation, emotional distress, and SP (range: β = 0.049–0.658). Bootstrapping analysis showed that activity limitation and emotional distress serially mediated the relationship between pain intensity and SP (total effect: β = 0.264, Bootstrap 95% confidence interval [CI] = 0.165–0.362; direct effect: (β = 0.107, Bootstrap 95% CI = 0.005–0.210; total indirect effect: β = 0.156, Bootstrap 95% CI = 0.005–0.210) accounting for ∼59%. Activity limitation and emotional distress mediated pain interference and SP association (total effect: β = 0.404, Bootstrap 95% CI = 0.318–0.490; direct effect: β = 0.292, Bootstrap 95% CI = 0.201–0.384; and total indirect effect: β = 0.112, Bootstrap 95% CI = 0.069–0.156) yielding ∼28%.

Conclusion

Our data suggest that activity limitation and emotional distress may convey stress-related risks of pain on SP. Future research should evaluate if activity limitation and emotional distress could be effective targets to reduce the effect of pain on sleep in later-life.

Original languageEnglish
JournalAmerican Journal of Geriatric Psychiatry
Early online date20 Apr 2024
DOIs
Publication statusE-pub ahead of print - 20 Apr 2024

Bibliographical note

Publisher Copyright:
© 2024 American Association for Geriatric Psychiatry

Keywords

  • emotional distress
  • middle-aged and older adults
  • pain intensity
  • Pain interference
  • sleep health
  • sub-Saharan Africa

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