Objectives Our primary aim was to evaluate the agreement between subjective and objective methods of measuring sleep quality in a musculoskeletal pain sample. Secondly, we aimed to explore the relationship between subjective and objective sleep quality (and its impact on function) and clinical and experimental pain. Methods We assessed subjective sleep using the Pittsburgh Sleep Quality Index (PSQI) and objective sleep using the Oura ring, a wearable characterizing sleep stages. Participants had musculoskeletal pain (intensity>4/10 most days in past 3 months) and poor sleep (PSQI total>5). To enable direct comparisons, via correlations, between subjective and objective sleep (primary aim), we emulated the equivalent of PSQI's answers and components by averaging the appropriate Oura data over the month covered by the PSQI. We used partial correlations to assess sleep-pain relationships (second aim), controlling for age and sex. Results Answers to PSQI questions about total bedtime and sleep duration, and the PSQI duration component, correlated with their Oura equivalents, whereas PSQI failed to capture Oura's Sleep Latency, Efficiency, and Disturbances. On the other hand, PSQI total score and its sleep latency component correlated with WOMAC-pain score, MPQ scores (total, neuropathic, continuous, and intermittent) and GCPS-pain intensity, while Oura's Sleep Latency correlated with conditioned pain modulation. No significant association between Oura measures and pain was found. Conclusions The findings highlight the complementary roles of subjective and objective measures and the need for integrated approaches to refine sleep assessments in musculoskeletal pain. Future studies should investigate the causes of these discrepancies to enhance understanding of sleep-related health outcomes.

The authors have declared no competing interest.

NCT04683640

This work was supported by NIH/NIA Grants T32AG049673 and P30AG059297 (SMG), K01AG083228 (PAVH), R01AG059809 and R01AG067757 (YCA). A portion of this work was performed in the McKnight Brain Institute at the National High Magnetic Field Laboratory's Advanced Magnetic Resonance Imaging and Spectroscopy (AMRIS) Facility, which is supported by National Science Foundation Cooperative Agreement No. DMR-1157490 and DMR-1644779 and the State of Florida. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funding agencies.

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