{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:17:16Z","timestamp":1791357436557,"version":"4.3.1"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,6,14]],"date-time":"2020-06-14T00:00:00Z","timestamp":1592092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003945","name":"Link\u00f6pings Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003945","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010805","name":"Forskningsr\u00e5det i Syd\u00f6stra Sverige","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010805","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent evidence suggests that insomnia negatively influences the occurrence of generalized pain. This study examined whether insomnia is a risk factor for the transition from local pain (LP) to generalized pain (i.e. spreading of pain).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This longitudinal study, with a follow\u2010up of 24\u00a0months, included 959 participants (mean age: 55.8\u00a0years;\n                      <jats:italic>SD<\/jats:italic>\n                      : 13.9) with local or regional pain at baseline. Participants were grouped by insomnia symptoms as measured by the Insomnia Severity Index. Spreading of pain was measured by body manikins based on the spatial distribution of pain on the body. We defined two outcome categories; one with relatively localized pain (i.e. LP and moderate regional pain [MRP]), and one with relatively generalized pain (i.e. substantial regional pain and widespread pain [WSP]). Baseline age, sex, education, depressive symptoms, anxiety symptoms, catastrophizing, pain intensity and spread of pain were also included in the Generalized Linear Model analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The unadjusted model showed that the risk of spreading of pain increased with an increase in insomnia symptoms (no insomnia: 55.4%; subthreshold insomnia: 25.4% moderate insomnia: 16.5% and severe insomnia: 2.7%). The risk increased in a dose\u2010dependent manner; moderate insomnia risk ratio (RR) 2.34 (95% confidence interval [CI]: 1.34\u20134.09) and severe insomnia RR 4.13 (95% CI: 1.56\u201310.92). The results were maintained in the fully adjusted model although MRP was the strongest predictor RR 6.95 (95% CI: 3.11\u201315.54).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings show a strong prospective relationship between insomnia symptoms and the transition from relatively localized to generalized pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>This study shows that people with LP conditions are at much higher risk of developing WSP if they also have significant insomnia symptoms. The elevated risk is evident after 24\u00a0months and increases in a dose\u2010dependent manner regarding the degree of exposure to insomnia symptoms. Local pain conditions are quite common in primary care, and an evaluation of the insomnia symptoms is highly recommended since the most common sleep problems can be treated effectively if detected.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.1582","type":"journal-article","created":{"date-parts":[[2020,5,9]],"date-time":"2020-05-09T17:09:10Z","timestamp":1589044150000},"page":"1348-1356","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Insomnia is a risk factor for spreading of chronic pain: A Swedish longitudinal population study (SwePain)"],"prefix":"10.1002","volume":"24","author":[{"given":"Tobias","family":"Wiklund","sequence":"first","affiliation":[{"name":"Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Gerdle","sequence":"additional","affiliation":[{"name":"Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Linton","sequence":"additional","affiliation":[{"name":"Center for Health and Medical Psychology (CHAMP) School of Law, Psychology and Social Work \u00d6rebro University \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Dragioti","sequence":"additional","affiliation":[{"name":"Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britt","family":"Larsson","sequence":"additional","affiliation":[{"name":"Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-2162"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2013.864712"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(00)00065-4"},{"key":"e_1_2_8_5_1","first-page":"818","article-title":"Chronic widespread pain: A three year followup of pain distribution and risk factors","volume":"29","author":"Bergman S.","year":"2002","journal-title":"The Journal of Rheumatology"},{"key":"e_1_2_8_6_1","volume-title":"Summary and conclusions of the SBU report: Treatment of insomnia in adults : A systematic review : June 2010","author":"Bevenius\u2010Carrick J.","year":"2010"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2005.06.009"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2009.31"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16122167"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S119845"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S143060"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(02)00138-0"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.53.100901.135243"},{"key":"e_1_2_8_14_1","first-page":"1","article-title":"A concurrent validational study of the NCHS General Well\u2010Being Schedule","volume":"2","author":"Fazio A. 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