OBJECTIVES: To evaluate pain severity and distribution

in relation to sleep difficulty in older adults.

DESIGN: Population-based cross-sectional study.

SETTING: Community within a 5-mile radius of the study

center at the Institute for Aging Research, Hebrew Senior-

Life (HSL), Boston.

PARTICIPANTS: Seven hundred sixty-five participants of

the Maintenance of Balance, Independent Living, Intellect,

and Zest in the Elderly (MOBILIZE) Boston Study aged 64

and older.

MEASUREMENTS: Pain severity was measured using the

Brief Pain Inventory (BPI) Pain Severity Subscale. Musculoskeletal pain distribution was grouped according to no pain, single site, two or more sites, and widespread pain

(upper and lower extremities and back pain). Three aspects

of sleep difficulty were measured using items from the Center for Epidemiologic Studies Depression Scale, Revised

(trouble getting to sleep, sleep more than usual, and restless

sleep).

RESULTS: Prevalence of trouble getting to sleep according

to BPI severity was 17.8%, 19.7%, 32.0%, and 37.0% for

the lowest to highest pain severity quartiles, respectively.

Similar relationships between pain and sleep were observed across sleep measures according to pain severity and distribution. Adjusted for sociodemographic characteristics, chronic conditions, and health behaviors, chronic pain was strongly associated with trouble sleeping (1 day per week) (singlesite pain, odds ratio (OR)51.77, 95% confidence interval (CI)51.10–2.87; multisite pain, OR52.38, 95% CI5 1.48–3.83; widespread pain, OR52.55, 95% CI51.43–

4.54, each compared with no pain). Similar associations

were observed for restless sleep and sleeping more than

usual. For specific pain sites alone or in combination with

other sites of pain, only modest associations were observed

with sleep problems.

CONCLUSION: Widespread or other multisite pain and

moderate to severe pain are strongly associated with sleep

difficulty in older adults. Further research is needed to better understand the burden and consequences of pain-related sleep problems in older adults. J Am Geriatr Soc 59:1385–1392, 2011.