The association between pain and sleep and their effects on health-related quality of life, wellbeing and disability in people presenting to healthcare clinics in New Zealand

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Roberts, Fraser
Author ORCID Profiles (clickable)
Master of Osteopathy
Unitec Institute of Technology
Shaikh, Shamim
Hach, Sylvia
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
New Zealand
health-related quality of life (HRQOL)
physical function
sleep quality
healthcare clinics
Roberts, F. (2019). The association between pain and sleep and their effects on health-related quality of life, wellbeing and disability in people presenting to healthcare clinics in New Zealand (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Osteopathy). Unitec Institute of Technology, Auckland, New Zealand, Retrieved from
INTRODUCTION: There is abundant evidence that sleep and pain are related. Sleep and pain also influence health-related quality of life (HRQOL), wellbeing, and physical disability. This study seeks to build upon existing New Zealand literature investigating pain, sleep, and HRQOL of individuals presenting to an osteopathic teaching clinic. AIM: To investigate the associations between sleep and pain and their effects on, health-related quality of life, wellbeing, and physical disability in New Zealand adults. METHOD: A composite online questionnaire was administered using SurveyMonkey and advertised online and at community centers/ libraries. Data was collected from adults with pain and/or sleep complaints in New Zealand. Quality of life was assessed using the 12-item Short Form Survey (SF-12v1); general well-being was assessed using the World Health Organisation WHO-5 index questionnaire; sleep quality and interference of pain on sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Pain and Sleep Questionnaire (PSQ-3) respectively; and physical disability was assessed using the Physical Disability Index (PDI). RESULTS: A total of 136 participants (age M = 40.53 years, SD = 14.42) were included. Almost all of the participants (94.4%) reported ‘poor’ sleep quality, as measured by the PSQI. Mean sleep duration was less than six hours. The majority (84.6%) of respondents had been affected by moderate pain for more than three months. Mild to moderate disability in physical and mental aspects of health were also reported. There was a significant difference between PSQ-3 scores for respondents affected by no or mild pain and those affected by severe pain and between respondents affected by pain in the timeframe of six weeks to three months and those affected by chronic pain. Poor sleep quality, higher pain intensity, and longer pain duration were associated with significant decreases in HRQOL and wellbeing status- primarily the physical component. Poor sleep quality was also significantly associated with moderate disability and the mental health component of respondents’ HRQOL. CONCLUSIONS: The results were consistent with local and wider existing research. Close associations between sleep quality, pain intensity and duration, HRQOL, and wellbeing highlight the importance of future research for multifaceted therapeutic management of pain. Supplementing traditional methods of treatment with sleep interventions and support for daily mental and physical function, where appropriate, may be indicated in future ‘best practice’ pain or sleep management. Further research involving larger populations and longitudinal methodology needs to be undertaken to understand causal relationships between sleep, pain, and HRQOL in a New Zealand population.
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