Back Pain Is Linked to Worse Sleep Years Later in Men Over 65

Back pain and sleep problems are two of the most common health complaints among older adults, and new research suggests they may be more closely connected than previously thought. A recent long-term study focusing on men over the age of 65 has found that back pain can increase the risk of developing sleep problems years later, while poor sleep does not appear to raise the risk of future back pain. This finding helps clarify the direction of the relationship between pain and sleep and highlights why early pain management may play a key role in healthy aging.

Researchers from Penn State University analyzed data collected over several years to better understand whether back pain leads to sleep problems or whether sleep issues contribute to later pain. Their conclusion was clear: back pain tends to come first, and its effects on sleep can linger for years.

How Common Are Back Pain and Sleep Problems in Older Men?

According to the researchers, about half of older men experience back pain, sleep problems, or both. These issues are not minor inconveniences. Chronic back pain can interfere with daily activities, limit mobility, and reduce overall quality of life. Sleep problems, on the other hand, are linked to a wide range of health concerns, including memory decline, mood disorders, and a higher risk of falls.

Despite how often these two conditions occur together, it has long been unclear which one usually comes first. Many earlier studies relied on short-term data or focused on younger populations. This new research stands out because it followed older men over a long period, allowing scientists to examine how back pain and sleep problems unfold over time.

Inside the Study: Who Was Studied and How

The study was based on data from the Osteoporotic Fractures in Men (MrOS) Study, a large and well-established research project in the United States. For this specific analysis, researchers looked at 1,055 men aged 65 and older.

Participants completed two in-depth clinical sleep assessments, spaced six or more years apart. Between these two sleep visits, the men regularly reported on their back pain through mailed questionnaires sent every four months. This frequent tracking allowed the researchers to capture changes in both the severity and frequency of back pain over time.

Sleep problems were assessed using a combination of clinical measures and self-reported information. These included factors such as irregular sleep patterns, short or insufficient sleep duration, daytime sleepiness, and overall satisfaction with sleep quality. By combining multiple indicators, the researchers created a comprehensive sleep problem score for each participant.

Measuring Back Pain and Sleep Over Time

To better understand long-term patterns, the researchers compiled each participant’s back pain reports over the course of one year. From this data, they created scores reflecting how often the men experienced back pain and how severe it was. Some reports also captured whether the pain limited normal activities.

Once these scores were established, the team compared them with sleep problem scores collected years later. They also reversed the analysis, examining whether early sleep problems predicted back pain six years down the line. This two-way approach helped clarify the direction of the relationship between pain and sleep.

What the Researchers Found

The results showed a consistent pattern. Men who reported back pain were more likely to experience sleep problems years later, even after accounting for other factors. Depending on the severity and frequency of the pain, back pain was linked to a 12% to 25% increase in sleep problems six years later.

In contrast, the researchers found no evidence that sleep problems predicted future back pain. This suggests that while pain can disrupt sleep over the long term, poor sleep alone may not be enough to trigger chronic back pain in older men.

More specifically, men with back pain were more likely to fall asleep too early or too late, report dissatisfaction with their sleep, and experience irregular sleep patterns. These changes may reflect how chronic pain interferes with the body’s natural sleep-wake rhythms.

Why This Matters for Older Adults and Caregivers

Understanding that back pain often precedes sleep problems has important implications for older adults, caregivers, and healthcare providers. Sleep issues in later life are linked to a range of serious outcomes, including cognitive decline, depression, anxiety, and a higher risk of falls and injuries.

If back pain is an early warning sign of future sleep trouble, addressing it sooner rather than later could help prevent a cascade of related health problems. The researchers emphasize the importance of acknowledging pain rather than dismissing it as a normal part of aging.

For caregivers and family members, noticing ongoing back pain in an older loved one may be a signal to encourage medical evaluation and appropriate treatment.

Treatment and Management Options

The study does not recommend a single solution for managing back pain, but it highlights the importance of working with a clinician to find an appropriate approach. Depending on the individual, this could include physical therapy, targeted exercise, pain management strategies, or other interventions.

Effective pain management may not only reduce discomfort but also help preserve healthy sleep patterns, which are essential for long-term well-being.

Limitations of the Research

While the findings are significant, the researchers also note some limitations. The study included only men, and most participants were White, meaning the results may not fully apply to women or people from other racial and ethnic backgrounds. Further research is needed to determine whether the same patterns hold true in more diverse populations.

Additionally, as an observational study, the research shows strong associations over time but cannot prove direct causation.

Why Pain and Sleep Are So Closely Connected

Pain and sleep influence each other in complex ways. Chronic pain can make it harder to fall asleep, stay asleep, or achieve deep, restorative rest. Over time, disrupted sleep can affect hormone regulation, inflammation, and pain sensitivity, potentially worsening overall health.

In older adults, these effects may be amplified by age-related changes in sleep architecture and physical resilience. This makes early intervention especially important.

Looking Ahead

This study adds valuable clarity to a long-standing question about pain and sleep in older age. By showing that back pain often comes before sleep problems, it underscores the need to take pain seriously and manage it proactively.

As the population continues to age, research like this helps guide better care strategies aimed at maintaining mobility, independence, and quality of life well into later years.

Research reference:
https://academic.oup.com/innovateage/article/9/11/igaf113/8283547