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

doi:10.1016/j.jagp.2024.04.011

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

Department of Sociology and Social Policy

Research output: Journal Publications › Journal 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 language	English
Pages (from-to)	1231-1243
Number of pages	13
Journal	American Journal of Geriatric Psychiatry
Volume	32
Issue number	10
Early online date	20 Apr 2024
DOIs	https://doi.org/10.1016/j.jagp.2024.04.011
Publication status	Published - Oct 2024

Bibliographical note

Publisher Copyright:
© 2024 American Association for Geriatric Psychiatry

Funding

This work was supported by the Research Grant Council and Lingnan University, Hong Kong [grant number RPG1129310 ]. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript. The authors declare no conflict of interest.

Keywords

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jagp.2024.04.011

https://linkinghub.elsevier.com/retrieve/pii/S106474812400318X

Cite this

GYASI, R. M., AIKINS, E., DUMEDAH, G., GYASI-BOADU, N., FRIMPONG, P. B., BOAMPONG, M. S., BUOR, D., MARIWAH, S., NAAB, F., & PHILLIPS, D. R. (2024). Risk of sleep problems in middle-aged and older adults experiencing bodily pains : Serial multiple mediation estimates of emotion distress and activity limitations. American Journal of Geriatric Psychiatry, 32(10), 1231-1243. https://doi.org/10.1016/j.jagp.2024.04.011

@article{a860ccee99324adba0119c2e7d694c6f,

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

abstract = "ObjectivesPain 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.MethodsWe 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.ResultsRegressions 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%.ConclusionOur 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.",

keywords = "emotional distress, middle-aged and older adults, pain intensity, Pain interference, sleep health, sub-Saharan Africa",

author = "GYASI, {Razak M.} and Emelia AIKINS and Gift DUMEDAH and Nelson GYASI-BOADU and FRIMPONG, {Prince Boakye} and BOAMPONG, {Mary Sefa} and Daniel BUOR and Simon MARIWAH and Francis NAAB and PHILLIPS, {David R.}",

note = "Publisher Copyright: {\textcopyright} 2024 American Association for Geriatric Psychiatry",

year = "2024",

month = oct,

doi = "10.1016/j.jagp.2024.04.011",

language = "English",

volume = "32",

pages = "1231--1243",

journal = "American Journal of Geriatric Psychiatry",

issn = "1064-7481",

publisher = "Elsevier B.V.",

number = "10",

}

GYASI, RM, AIKINS, E, DUMEDAH, G, GYASI-BOADU, N, FRIMPONG, PB, BOAMPONG, MS, BUOR, D, MARIWAH, S, NAAB, F & PHILLIPS, DR 2024, 'Risk of sleep problems in middle-aged and older adults experiencing bodily pains : Serial multiple mediation estimates of emotion distress and activity limitations', American Journal of Geriatric Psychiatry, vol. 32, no. 10, pp. 1231-1243. https://doi.org/10.1016/j.jagp.2024.04.011

Risk of sleep problems in middle-aged and older adults experiencing bodily pains : Serial multiple mediation estimates of emotion distress and activity limitations. / GYASI, Razak M.; AIKINS, Emelia; DUMEDAH, Gift et al.
In: American Journal of Geriatric Psychiatry, Vol. 32, No. 10, 10.2024, p. 1231-1243.

Research output: Journal Publications › Journal Article (refereed) › peer-review

TY - JOUR

T1 - Risk of sleep problems in middle-aged and older adults experiencing bodily pains : Serial multiple mediation estimates of emotion distress and activity limitations

AU - GYASI, Razak M.

AU - AIKINS, Emelia

AU - DUMEDAH, Gift

AU - GYASI-BOADU, Nelson

AU - FRIMPONG, Prince Boakye

AU - BOAMPONG, Mary Sefa

AU - BUOR, Daniel

AU - MARIWAH, Simon

AU - NAAB, Francis

AU - PHILLIPS, David R.

PY - 2024/10

Y1 - 2024/10

N2 - ObjectivesPain 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.MethodsWe 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.ResultsRegressions 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%.ConclusionOur 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.

AB - ObjectivesPain 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.MethodsWe 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.ResultsRegressions 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%.ConclusionOur 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.

KW - emotional distress

KW - middle-aged and older adults

KW - pain intensity

KW - Pain interference

KW - sleep health

KW - sub-Saharan Africa

UR - http://www.scopus.com/inward/record.url?scp=85192151874&partnerID=8YFLogxK

U2 - 10.1016/j.jagp.2024.04.011

DO - 10.1016/j.jagp.2024.04.011

M3 - Journal Article (refereed)

C2 - 38702252

SN - 1064-7481

VL - 32

SP - 1231

EP - 1243

JO - American Journal of Geriatric Psychiatry

JF - American Journal of Geriatric Psychiatry

IS - 10

ER -

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

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

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