{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:44:06Z","timestamp":1791837846326,"version":"4.3.4"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Chronic pain is a common condition which causes patients much suffering and is very costly to society. Factors known to be associated with chronic pain include female gender, acute pain, depression, and anxiety. This study investigated whether stress, sleep disturbance, and physical inactivity were risk factors for developing chronic pain among young adults, and whether there were any interactions between these.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This retrospective longitudinal study was based on an existing database from a cohort study on IT use and health, called Health 24 Years. A questionnaire was sent to students aged 19\u201324 in Sweden for five consecutive years, containing questions on pain, stress, sleep, physical activity, technology use, health, and more. In logistic regressions, stress, sleep, and physical activity at baseline were potential predictors of chronic pain one and four years later. In addition, a new variable including all possible interactions between potential predictors was created to test for effect modification between risk factors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>At the one-year follow-up, stress, non-restorative sleep, and physical inactivity showed odds ratios of 1.6 (95% CI: 1.0\u20132.4), 1.5 (95% CI: 1.0\u20132.3), and 1.8 (95% CI: 1.1\u20133.0) respectively after adjusting for confounders, the reference being non-stressed, having restorative sleep and being active. At the four-year follow-up, stress showed an adjusted odds ratio of 1.9 (95% CI: 1.3\u20132.9), while non-restorative sleep and physical inactivity were statistically insignificant. At the one-year follow-up, the interaction between risk factors were significant. The most clear example of this effect modification was to be inactive and not have -restorative sleep, compared to individuals who were active and had restorative sleep, showing an adjusted odds ratio of 6.9 (95% CI: 2.5\u201319.2) for developing chronic pain one year after baseline. This in comparison of odds ratios for only inactive respectively only non-restorative sleep being 1.7 (95% CI: 0.6\u20135.3) respectively 1.6 (95% CI: 0.7\u20133.5).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Stress, non-restorative sleep, and physical inactivity were risk factors for developing chronic pain one year after baseline, and stress were also a risk factor four years after baseline. These findings suggest that non-restorative sleep and inactivity are risk factors in the short term while stress is a risk factor in both the short and the long term. In addition to the independent effects of non-restorative sleep and inactivity, their combination seems to further increase the odds of chronic pain.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0262601","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T18:39:22Z","timestamp":1642790362000},"page":"e0262601","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":47,"title":["Stress, non-restorative sleep, and physical inactivity as risk factors for chronic pain in young adults: A cohort study"],"prefix":"10.1371","volume":"17","author":[{"given":"Maja","family":"Lindell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9408-6065","authenticated-orcid":true,"given":"Anna","family":"Grimby-Ekman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"key":"pone.0262601.ref001","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1186\/1471-2458-11-770","article-title":"Pain as a global public health priority","volume":"11","author":"DS Goldberg","year":"2011","journal-title":"BMC public health"},{"issue":"4","key":"pone.0262601.ref002","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.ejpain.2005.06.009","article-title":"Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment.","volume":"10","author":"H Breivik","year":"2006","journal-title":"European journal of pain"},{"issue":"6","key":"pone.0262601.ref003","first-page":"1369","article-title":"Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study","volume":"28","author":"S Bergman","year":"2001","journal-title":"The Journal of rheumatology"},{"issue":"6","key":"pone.0262601.ref004","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-010364","article-title":"Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies","volume":"6","author":"A Fayaz","year":"2016","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0262601.ref005","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.ejpain.2011.07.006","article-title":"Socio-economic burden of patients with a diagnosis related to chronic pain\u2014register data of 840,000 Swedish patients","volume":"16","author":"A Gustavsson","year":"2012","journal-title":"European Journal Of Pain (London, England)."},{"issue":"1","key":"pone.0262601.ref006","first-page":"19","article-title":"Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11).","volume":"160","author":"R-D Treede","year":"2019"},{"issue":"2","key":"pone.0262601.ref007","doi-asserted-by":"crossref","first-page":"e273","DOI":"10.1016\/j.bja.2019.03.023","article-title":"Chronic pain: a review of its epidemiology and associated factors in population-based studies. 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