Association of Painful musculoskeletal conditions and migraine headache with mental and sleep disorders among adults with disabilities, Spain, 2007-2008.

Introduction: The aim of the study was to determine the prevalence of musculoskeletal painful conditions and migraine/headache in a population with disabilities, and their association with anxiety, depression and sleep disorders. Methods: This cross-sectional study analyzed data from the Spanish Disability-Dependence Survey on 16932 subjects ≥18 years-of-age that suffer disabilities. The prevalence (CI 95%) of musculoskeletal painful conditions was considered through the diagnosis of arthritis, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, muscular dystrophy and neck or back pain. The prevalence of migraine/headache was also calculated. Factors associated to these painful conditions were analyzed separately for each sex using a logistic regression model. Results: The prevalence of musculoskeletal painful conditions was 66.9% (CI 95%: 66.2-67.6) and that of migraine/headache was 23.4% (CI95%:22.8-24.1), both of which were higher in women than in men. Factors associated to these painful conditions in both men and women included increased age, sleeping less than 6 hours, and concomitant chronic anxiety and/or depression. Conclusion: The prevalence of musculoskeletal painful conditions and migraine/headache is high in individuals with disability in Spain, especially in women, and these conditions often coexist with depression, anxiety and/or sleep disturbances. Our findings suggest that mental and/or sleep disorders should be considered alongside conventional treatments in subjects with disability and specific painful conditions in order to design effective programs to rehabilitate them and improve their quality of life