Psychosocial factors and sleep disorders associated with chronic musculoskeletal pain in university students: a cross-sectional study

Abstract

Introduction: Academic setting is related to changes in the circadian cycle as well as in the lifestyle of people involved in this environment, contributing to a maximization of chronic pain inherent factors, mainly low back pain. Objective: To investigate the association between sleep disorders, biopsychosocial factors, and lifestyle to chronic musculoskeletal pain in undergraduate students. Methods: The thesis was divided into two cross-sectional studies with a non-probabilistic convenience sample (611 undergraduates from the countryside of Ceará). Eligibility criteria were: being above 18 years; both sexes; regularly enrolled in the university; and who have responded to all questionaries properly. Some questionaries were used to assess variables involved in these studies: a sociodemographic questionary (sex, age, lifestyle, virus infections, the Mini Sleep Questionary (MSQ), a biopsychosocial aspects triage questionary, and a Corlett diagram to evaluate the presence, frequency, and chronicity of the pain musculoskeletal. Data analysis resulted describe the sociodemographic profile using the mean and standard deviation. To measure associations, a multivariate analysis through a logistic regression was used. In this analysis, dependent variables and sleep disorders, stress, anxiety, depression, COVID-19 and/or Chikungunya infection, and regular exercise practice were associated. Besides that, to assess the relation between physical activity practice, sleep, age, medicine intake, anxiety, stress, depression to low back pain, other logistic regression was accomplished. All significance levels were admitted as α <0,05. Potential confounders were included in the final model obtaining a significance of p<0,2 in the univariate analysis performed in RStudio. Results: Participants reported the presence of pain (n430, 70.3%), chronic pain (n=288,47,1%). In the first study, chronic pain was related to sleep disorders (OR = 1.620, IC 95% 1.093–2.402), sleeping drugs (OR = 2.498, IC 95% 1.038-6.014), depression (OR = 1.108, IC 95% 1.038–1.182), and not being physically active (OR = 1.502, IC 95% 1.048-2.153). Besides that, an association was observed between exercise practice and depression for women and sleep disorders and chronic pain for men. In the second study, the results show an association between low back pain and sleep disorders (OR = 1.915, IC 95% 1.200-3.059) and stress (OR = 1.071, IC 95% 1.001-1.181). Conclusion: Findings highlight the necessity of considering psychological factors, physical activity practice, and sleep quality when investigating chronic pain among undergraduate students, especially for low back pain. Thus, these results add to health professionals' guiding approaches based on adequate strategies considering mainly sex differences to prevent pain.