A new study shows that in men over the age of 65, back pain can gradually lead to worsening sleep quality.

Researchers found that men with back pain are more likely to develop sleep problems over time. The relationship appears to be one-directional: back pain comes first, followed by poor sleep.

“We know that back pain and sleep are serious issues for older adults,” said Soomi Lee, associate professor of Human Development and Family Studies at Pennsylvania State University and lead author of the study.

“We analyzed data collected over several years to understand whether poor sleep predicts back pain or, conversely, whether back pain predicts poor sleep, and we found that the latter is true,” she added, as reported by Euronews.

According to Lee, the fact that back pain seems to precede sleep problems suggests that effective pain management may be necessary to ensure good sleep quality and to prevent broader health problems.

The study, published in the journal Innovation in Aging, is based on data from the long-running Osteoporotic Fractures in Men study, which follows older men to better understand aging and the development of chronic conditions.

The researchers analyzed data from 1,055 older men who underwent clinical sleep assessments at intervals of six years or more and, in the periods between these assessments, answered questions every four months about the severity and frequency of their back pain.

Using self-reported back pain data, the research team compared sleep problems between the two sleep assessments.

The results showed that back pain predicted an increase in sleep problems in men six years later by 12% to 25%.

In addition to sleep duration, the study examined issues such as irregular sleep patterns, difficulty maintaining sleep, and excessive daytime sleepiness.

The Pennsylvania State University study also explored a possible bidirectional relationship between back pain and sleep problems. However, after analyzing the data, the researchers found that sleep problems did not predict future back pain.

The authors note that the findings are based on observational data primarily from older White men, so the results may not fully generalize to women or more diverse populations.

“If caregivers or loved ones notice problems related to back pain, this may be a warning sign,” Lee said.

She added that older adults should acknowledge and address their back pain to prevent future sleep disturbances and other health problems associated with insufficient sleep, including memory decline, depression, anxiety, and falls.

High-quality sleep in older adults is closely associated with better physical health, slower cognitive decline, and a lower risk of mortality.

Recent studies have shown that people with chronic insomnia—defined as difficulty sleeping at least three nights per week for three months or longer—have a 40% higher risk of developing dementia or mild cognitive impairment compared with those who sleep normally.