Pain burden and sleep quality in community-dwelling adults aged ≥50 years in Ghana: potential psychosomatic mechanisms

Objectives: Pain has been related to adverse health outcomes in old age. However, evidence from low-income countries is limited, and the potential mediators are poorly understood. Therefore, the aim of this study was to analyze the association between pain burden (PB) and sleep problems (SP) among older adults in Ghana and explore potential psychosomatic mediators.

Method: We analyzed data from the Aging, Health, and Health-seeking Behavior study administered to 1201 adults aged ≥50 years. PB was assessed using the pain subscale of the Medical Outcomes Study Short Form-36. SP was assessed using nighttime/daytime SP in the last 30 days. Multivariable OLS and mediation models evaluated the hypotheses.

Results: Mean (SD) age was 66.14 (11.85) years, and 63.3% were women. After full adjustment, PB (versus no PB) was positively associated with SP in the overall sample (b = 0.227, 95% CI = 0.124 − 0.331) and women (b = 0.363, 95% CI = 0.233 − 0.492) but not in men. Moreover, the association was pronounced in the ≥65 year group (b = 0.317) than in the 50-64 year group (b = 0.216). Self-rated health (54.4%), immobility (23.4%), physical activity (12.2%), restlessness (12.1%), depression (6.4%), anxiety (6.3%), and social isolation (7.2%) mediated the PB-SP association.

Conclusion: PB was positively associated with SP among older adults in Ghana. Bio-psychosomatic factors were identified as potential mediators in this association. Addressing these factors may improve sleep health in older adults with pain.