Relationship between smoking, sleep, and chronic pain in the National Health Interview Survey

It has been well documented that the rates of smoking in individuals with chronic pain are higher than in the general population. In addition, chronic pain is associated with interference in other health behaviors such as sleep. Specifically, it has been shown that individuals with chronic pain report averaging less sleep efficiency (i.e. amount of restful sleep in proportion to time spent in bed) compared to the general population. This lack of restorative sleep is predictive of a number of negative outcomes including increased pain and poorer overall functioning. However, to date, these findings have been limited to clinical samples. Therefore, the purpose of this study was to examine the relationship between cigarette smoking and sleep in a population sample of individuals diagnosed with a rheumatologic condition and accompanying functional impairment (CP). This study found that CP individuals were 1.36 times more likely to be a current smoker than those without a pain diagnosis. Moreover, we found that those with CP were over 1.5 times more likely to report getting less than 6 hours of sleep per night and endorsed significantly more insomnia and daytime sleepiness than their non CP counterparts. Finally, an interaction was observed that suggested that CP individuals who currently smoke are significantly more likely to report averaging less than 6 hours of sleep per night (25.3%) and frequent insomnia (60.8%) compared to CP individuals who have never smoked (14.5% and 40.1% respectively). Implications of these findings and future directions are discussed.