Physical activty, sleep, and pain in individuals with chronic pain

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[EMBARGOED UNTIL 08/01/2026] Introduction Physical activity, sleep, and pain are inter-related such that greater pain is linked to poorer sleep and vice versa, and individuals with chronic pain often avoid physical activity due to anticipated worsening of pain and sleep. The current Dissertation examines whether the relationship between physical activity and sleep is moderated or mediated by pain. Methods A sample of 994 adults (517 no chronic pain, 477 chronic pain) completed a survey measuring physical activity, pain, and sleep. Multiple linear regressions examined whether chronic pain status moderated the relationship between physical activity and sleep. Additionally, two samples of individuals with chronic pain (n=95, n=468) completed two weeks of daily subjective and objective physical activity, pain intensity, and sleep assessments. Multi-level moderation and mediation models examined whether average and daily evening pain intensity moderates or mediates the relationship between average and daily physical activity and sleep. Results Findings were largely consistent across moderation and mediation models such that chronic pain status and evening pain intensity did not moderate nor mediate the relationship between physical activity and sleep. Conclusion The current results suggest that physical activity does not lead to increased evening pain intensity and subsequent impaired sleep. Clinical recommendations regarding physical activity and sleep in healthy adults may largely apply to individuals with chronic pain as well.

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