Pain-induced sleep disturbances fully mediate the association between symptomatic hip and knee osteoarthritis and poor sleep quality

Symptomatic end-stage hip and knee OA are strongly associated with worse sleep quality, which is fully mediated by pain-related sleep disturbances. While the cross-sectional design limits causal inferences, these findings underscore the importance of improving both sleep quality and pain management strategies in symptomatic end-stage OA patients. Addressing sleep disturbances, which are often overlooked in clinical practice, could significantly enhance overall health and quality of life of patients with end-stage hip- or knee OA.