Neighborhood Disorder and pain: Sociodemographic moderators and mediating role of sleep

Abstract

Adequate sleep is a central component of behavioral health and researchers have suggested that sleep disturbance is a chief risk factor for poor physical and mental health, including pain. Pain and sleep disturbance are highly comorbid and have a complex relationship. Contextual factors, such as neighborhood, may be related to disparities in pain and sleep experienced by Blacks/African Americans and individuals with lower SES. Neighborhood factors are related to poor sleep quality and more sleep problems, and sleep problems are known to have a strong relationship with pain. A small literature examining the relationship between neighborhood disadvantage and pain has found that greater neighborhood disadvantage is related to more frequent experiences of pain. Underlying mechanisms for this association remain unclear. The present study evaluated whether race and/or poverty status, moderated the relation of perceived Neighborhood Disorder (ND) and pain intensity or pain interference. Second, the study examined whether sleep duration, sleep quality, or global sleep mediated the relation between perceived ND and pain outcomes and explored whether mediating effects differed by race and/or poverty status. Lastly, the study explored whether adjusting for depressive symptoms accounted for significant mediational pathways found in Aim 2. Participants were drawn from Wave 4 of the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (n = 1,071). Results of the study revealed that neither race or poverty status moderated the relation of perceived ND and pain intensity or pain interference. Results revealed mediating effects of sleep quality and global sleep on the relation of perceived ND and pain intensity and pain interference, but these effects did not vary by race and/or poverty status. Results revealed that mediating effects of sleep quality and global sleep on the relation of perceived ND and pain intensity and pain interference remained significant after adjustment for depressive symptoms. These findings provide preliminary evidence to support the notion that select sleep dimensions, particularly sleep quality, is a pathway by which subjective neighborhood factors may impact pain intensity and pain interference. More research is needed to understand potential pathways underlying the perceived ND and pain relation.