The association between low back pain and sleep quality in adults 60 years and older: a systematic review.

Abstract

Poor sleep quality is a health concern in older adults, with low back pain (LBP) as a hypothesized risk factor. We aimed to synthesize evidence on the association between LBP and sleep quality among adults ≥ 60 years. We conducted a systematic review, registered protocol (Open Science framework #u7bc4) and reported it according to PRISMA. We searched MEDLINE, Embase, CINAHL, and PsycINFO (inception to December 2025). We included cross-sectional, cohort, and case-control studies on LBP and sleep quality among adults ≥ 60 years. We utilized a combination of OpenAI's ChatGPT and fluent members in our team to translate non-English studies after which we screened and assess their quality. We synthesized evidence from low and moderate risk of bias studies. Our search retrieved 2394 articles. After removing duplicates, we screened 2237 citations for eligibility, with 191 studies eligible for full-text screening. 13 studies were relevant and appraised. Our synthesis includes five studies of moderate to low risk of bias (three cross-sectional and two cohort studies). Although measures of LBP and sleep quality varied across the included studies, all demonstrated an overall positive small association between the two constructs. Chronic LBP is positively associated with poor sleep quality in aging adults. Our study highlights methodological limitations in existing research and calls for more rigorous epidemiological studies.