Association of Sleep Quality Status With Worsening Low Back or Knee Pain During The COVID-19 State of Emergency Among Old-Old Adults

BACKGROUND: Poor sleep quality has a negative effect on pain among older adults. During the coronavirus disease 2019 (COVID-19) state of emergency, lifestyle changes can cause psychologic stressors and lead to poor sleep quality. AIM: This study examined whether sleep quality status was associated with low back or knee pain changes during the COVID-19 state of emergency among community-dwelling Japanese old-old adults. DESIGN: Cross-sectional investigation. METHODS: In July 2020, during the COVID-19 epidemic, we conducted a postal survey for old-old adults aged ≥77 years and collected data on 597 participants. For those who had low back or knee pain at the time of the survey (in July), characteristics such as low back pain, knee pain, changes in pain status, and sleep quality status during the COVID-19 state of emergency (in March) were assessed. RESULTS: Data from 597 participants showed the prevalence of low back pain (50.6%) and knee pain (40.7%) in July. Of those with low back or knee pain, 374 had pain changes during the state of emergency, with 12.3% worsening. Of these, 23.9% had poor sleep quality in March compared to non-change (p = .008). In a multivariate logistic regression model adjusted for potential confounders, poor sleep quality was significantly associated with pain worsening (odds ratio 2.80, 95% confidence interval 1.26-6.22). CONCLUSIONS: During the COVID-19 state of emergency, poor sleep quality was associated with worsening low back or knee pain. This may indicate the need to pay attention to poor sleep quality to prevent the exacerbation of pain among old-old adults.