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Physical work exposure, chronic musculoskeletal pain and risk of insomnia: longitudinal data from the HUNT study, Norway
  1. Eivind Schjelderup Skarpsno1,2,
  2. Tom Ivar Lund Nilsen1,3,
  3. Trond Sand2,4,
  4. Knut Hagen2,4,5,
  5. Paul Jarle Mork1
  1. 1Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  2. 2Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
  3. 3Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway
  4. 4Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  5. 5Norwegian National Headache Centre, St. Olavs Hospital, Trondheim, Norway
  1. Correspondence to Eivind Schjelderup Skarpsno, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway; eivind.s.skarpsno{at}


Objectives To prospectively investigate (i) the association of physical work demands and work-related physical fatigue with risk of insomnia symptoms and (ii) if these associations are influenced by chronic musculoskeletal pain.

Methods Prospective study on a working population of 8563 women and 7598 men participating in the Nord-Trøndelag Health Study (Norway) who reported no insomnia at baseline in 1995–1997. Occurrence of insomnia symptoms was assessed at follow-up in 2006–2008. A Poisson regression model was used to calculate adjusted risk ratios (RRs) for insomnia symptoms with 95% CI.

Results Compared with workers without work-related physical fatigue, women and men who reported that they were always fatigued had RRs of insomnia of 2.34 (95% CI 1.72 to 3.18) and 2.47 (95% CI 1.59 to 3.83), respectively. Overall, physical work demands was not associated with risk of insomnia, although men who reported heavy physical work had an RR of 0.67 (95% CI 0.47 to 0.97) compared with men with mostly sedentary work. Compared with the reference group of workers without work-related physical fatigue and no chronic pain, analyses of joint effects showed that women with excessive work-related fatigue had an RR of 4.20 (95% CI 2.95 to 5.98) if they reported chronic pain and an RR of 1.67 (95% CI 0.87 to 3.18) if they did not. Corresponding RRs in men were 3.55 (95% CI 2.11 to 5.98) and 2.13 (95% CI 1.07 to 4.25).

Conclusion These findings suggest that there is an interplay between work-related physical fatigue and musculoskeletal pain that should receive particular attention in the prevention of insomnia in working populations.

  • job demands
  • occupational load
  • musculoskeletal complaints
  • sleep problems
  • physical work
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  • Contributors Study concept and design, drafting of the manuscript, critical revision of the manuscript, statistical analysis, analysis and interpretation of data, critical revision and final approval: all authors.

  • Funding This work was supported by a grant to ESS from the Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU). Project number: 46056929.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the Regional Committee for Ethics in Medical Research (project no.2014/612 REK midt, Norway). The study was carried out according to the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Correction notice This article has been corrected since it first published online. The article type has been changed to ’Workplace'.

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