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Int J Behav Med. 2008;15(4):254-62. doi: 10.1080/10705500802365466.

Sleeping problems as a risk factor for subsequent musculoskeletal pain and the role of job strain: results from a one-year follow-up of the Malmö Shoulder Neck Study Cohort.

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Division of General Practice, Department of Clinical Sciences Malmo, Lund University, Malmö , Sweden.



The role of sleeping problems in the causal pathway between job strain and musculoskeletal pain is not clear.


To investigate the impact of sleeping problems and job strain on the one-year risk for neck, shoulder, and lumbar pain.


A prospective study, using self-administered questionnaires, of a healthy cohort of 4,140 vocationally active persons ages 45-64, residing in the city of Malmo.


At follow-up, 11.8% of the men and 14.8% of the women had developed pain. The odds ratios (OR) for pain at follow-up and sleeping problems at baseline were 1.72 (95% CI: 1.13-2.61) in men and 1.91 (1.35-2.70) in women. Regarding exposure to job strain, ORs were 1.39 (0.94-2.05) for men and 1.63 (1.18-2.23) for women. These statistically significant risks remained so when controlled for possible confounding. A modest synergistic effect was noted in women with concurrent sleeping problems and job strain, but not in men.


One in 15-20 of all new cases of chronic pain in the population could be attributed to sleeping problems. No evidence was found for a causal chain with job strain leading to musculoskeletal pain by the pathway of sleeping problems.

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