Impacts of sleep quality in young adults with a history of adolescent knee pain from a prospective population-based cohort in denmark

Background and aims: Studies have suggested that poor sleep is related to lowered quality of life (QoL) and decreased mental- and physical health, but this remains to be investigated in a larger cohort of young adults with a history of pain.

Methods: This cross-sectional exploratory study included 341 young adults with a history of adolescent knee pain from a population-based cohort. Participants rated four common sleep problems on a 3-point scale and were divided into groups based on cumulative scores with cutoffs at 4 (good sleepers), 8 (medium sleepers), and 12 points (poor sleepers), and were compared on pain, function, and QoL.

Results: Poor sleepers (n=62) had lower QoL (EQ-5D index-score, P<0.001) compared to medium (N=235) and good (N=44) sleepers. Poor sleepers more frequently reported knee pain (P<0.01, fig. 1), higher pain intensities (P<0.001, fig. 3), regular use of painkillers (P<0.01, fig. 1), and multiple painful body sites (P<0.001 fig. 3) compared to medium and good sleepers. Furthermore, poor sleepers more frequently reported reduced sports participation (P<0.01, fig. 1) and impact on job and/or education choice due to pain (P<0.01, fig. 1) compared to medium and good sleepers. Finally, poor sleepers had worse Knee Injury and Osteoarthritis Outcome Scores (KOOS) for function in daily living (ADL) compared to medium and good sleepers (P<0.001, fig. 2), while all other KOOS dimensions worsened progressively from good to poor sleepers (P<0.05, fig. 2).

Conclusions: Poor self-reported sleep impacts several important domains such as pain, QoL, and career choices in young adults with a history of pain.