Sleep problems, pain interference, and global subjective health outcome: Findings from a representative aging study in Ghana

We investigated the association between sleep problems and global self-rated health (SRH) in individuals aged ≥50 years in Ghana and explored the sex-wise mediating role of pain interference in this association. Data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study were analyzed (N=1201). Global SRH and pain interference were assessed with the Medical Outcomes Study (Short Form-36) Scale. Sleep-related problems were assessed on a 5-point scale from none=1 to extreme=5. Adjusted OLS regressions and bootstrapped mediation models evaluated the hypothesized associations. The mean (SD) age was 66.1 (11.9) years and 63.3 % were females. Sleep problems were associated with increases in pain interference (β = 0.320, p < 0.001) and poor SRH (β = 0.039, p < 0.001). Pain interference mediated 61.6% of the sleep problems-SRH association in the overall sample (β =0.063, Bootstrap 95%CI=0.014-0.034) and 36.7% among women (β =0.023, Bootstrap 95%CI=0.023-0.053). Effective sleep and pain management strategies may improve subjective health outcomes, particularly among older women.