Sleep complaints are common among older adults with chronic pain. Because of the risk of significant side effects, sleep medications are not recommended as first-line treatments. Little is known about the association between positive psychosocial factors and sleep, but further awareness could support non-drug strategies to minimize poor sleep. The purpose of this study was to (1) determine the prevalence of self-reported poor sleep quality and short/long sleep duration in a population of older adults with chronic pain, and (2) examine the associations of negative risk factors, sleep-inducing medications, and positive psychosocial characteristics on sleep outcomes in this population. This study analyzed survey responses from 4201 adults ages ‡65 years with diagnosed back pain, osteoarthritis, and/or rheumatoid arthritis, and at least 1 year of continuous medical and drug plan enrollment. The most commonly reported sleep outcome was short sleep duration (39%), followed by poor sleep quality (22%), and long sleep duration (9%). Based on pharmaceutical claims, prescriptions for opioids (59%) or benzodiazepines (22%) were common. Perceived stress, depression, and pain or sleep prescription medications were independently associated with poor sleep quality and short or long sleep durations. The positive psychosocial factors of higher resilience and more diverse social networks were independently associated with good sleep quality and optimal sleep duration. These results underscore the importance of social and coping factors to sleep, which may provide new opportunities to improve sleep and well-being in older adults with chronic pain.

Sleep complaints are common among older adults with pain. Due to the risk of side effects, sleep medications are not recommended. Little is known about the association between psychosocial factors and sleep, but further awareness could support non-drug strategies for poor sleep. Our objective was to determine prevalence of self-reported poor sleep and duration among older adults with pain; and examine associations of positive psychosocial characteristics on sleep. This study analyzed surveys and claims from older adults with AARP® Medicare Supplement plans insured by UnitedHealthcare. Participants were 65+ with diagnosed back pain, osteoarthritis and/or rheumatoid arthritis; 12-months plan enrollment. All participants responded to a survey in May 2018 assessing sleep quality. Prescriptions were determined from claims. Propensity weighting was used to adjust for non-response bias. Results were weighted to generalize to those with pain. Multivariate logistic regression was used to evaluate associations. Short sleep duration was most common (39%), followed by poor quality (22%), and long duration (9%). Higher resilience and diverse social networks were associated with good quality and duration. Strongest associations with bad quality and short duration were stress, depression and sleep medications. Psychosocial factors were strongly associated with sleep quality and duration among older adults with pain. Results underscore the importance of social factors on sleep and need for non-drug sleep strategies.