The Intersection of Sleep Disorders and Chronic Musculoskeletal Pain: A Narrative Review

Purpose of Review Chronic musculoskeletal (MSK) pain poses a major global health burden and is associated with sleep disorders through a bidirectional relationship. This review examines the neurobiological and psychosocial mechanisms, risk factors, and clinical implications relevant to chronic MSK pain and sleep disorders. Recent Findings Up to three-quarters of chronic non-cancer pain patients meet criteria for insomnia, with a higher prevalence of chronic MSK pain observed among women and older adults. The influence of psychological distress further perpetuates poor outcomes. Cognitive behavioral therapy for insomnia improves insomnia severity, sleep quality, and depressive symptoms; however, it has not been found to be effective in significantly reducing pain outcomes. Summary Chronic MSK pain and sleep disturbance exhibit a clinically significant bidirectional association, mediated by the interaction of psychological and neurophysiological pathways. Current treatments may focus on interventions that relieve pain, with sleep disturbance being secondary or not addressed. Routine screening, objective assessments, and integrated psychological and sleep-based interventions may improve outcomes in selected chronic pain populations.