Implications for practice and research

• Nurses should be aware of multiple physio-psychosocial factors and aetiologies of pain, sleep problems and anxiety and their cyclic interaction.

• Nurse researchers should develop patient assessment tools to identify personalised and contextual factors that strengthen the cycle of pain, anxiety and sleep problems.

Context

Sleep problems and chronic pain are liked reciprocally, and independently associated to reduced daily living activities, and mental and physical health.1 2 The relationship between sleep problems and pain is complex with interacting factors such as duration, intensity, and frequency of pain, symptoms and challenges of managing chronic illnesses, and anxiety related to pain or poor sleep. Miettinen et al studied factors differing patients with pain who have sleeping problems from …