• Siv Steinsmo Ødegård, Trond Sand, Morten Engstrøm, John-Anker Zwart, and Knut Hagen.
• Department of Neuroscience; Faculty of medicine, Norwegian University of Science and Technology, MTFS, Trondheim N-7489, Norway. sivstein@stud.ntnu.no
• J Headache Pain. 2013 Mar 12; 14: 24.

BackgroundA strong relationship between insomnia and painful disorders has been found, but it is still unclear whether chronic pain leads to insomnia. There is a need of large-scale prospective studies to evaluate if there is a causal relationship between painful disorders and insomnia.MethodsAll inhabitants aged ≥ 20 years in Nord-Trøndelag County of Norway were invited to participate in two surveys (n = 92,566 and 93,860, respectively). 27,185 subjects participated in both surveys, and 19,271 of these were insomnia-free at baseline (population at risk). Using logistic regression, we evaluated the influence of headache, CMSCs and coexisting headache and CMSCs on the subsequent risk of insomnia.ResultsCompared to subjects without headache and CMSCs, there was an increased risk of insomnia among those with headache, most pronounced among those with headache ≥ 7 days / month (OR = 2.2, 95% CI = 1.9 - 2.6). Similarly, an increased risk among those with CMSCs was found, most evident for those with widespread CMSCs (OR = 2.0, 95% CI = 1.8 - 2.2). Having coexistent CMSCs and headache (OR = 2.0, 95% CI = 1.8 - 2.2) predisposed more strongly to insomnia than having headache (OR = 1.5, 95% CI = 1.3 - 1.6) and CMSCs (OR = 1.6, 95% CI = 1.4 - 1.7) alone.ConclusionIn this prospective study headache and CMSCs were risk factors for insomnia 11 years later.

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