Sleep chronotype and its association with coexisting pain outcomes: a systematic review and meta-analysis

Mar 17, 2026Sleep medicine

Sleep timing preferences linked to different pain experiences: a review and combined analysis

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Participants with evening chronotype had a 54% higher risk of experiencing various types of pain.

Evening chronotype is linked to an increased risk of suffering from pain compared to other chronotypes.
The overall odds ratio for pain in evening chronotypes is 1.54, indicating a significant association.
Specific types of pain associated with evening chronotype include headache (odds ratio 1.32) and back pain (odds ratio 1.44).
Musculoskeletal pain shows an even higher association, with an odds ratio of 1.78 for evening chronotypes.

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AIMS: This study aimed to assess the association between evening chronotype and multidimensional pain.

METHODS: The database of PubMed, EMBASE, Web of Science, and Cochrane Library were searched for studies analyzing the pain among of different chronotypes until July 2025. If I< 50%, a combined analysis was performed based on a fixed-effects model, and vice versa, using a random-effects model. Odds Radio (OR) and 95% confidence intervals (CI) were used to analyze the association between chronotype and pain. 2

RESULTS: A total 18 studies were included in this meta-analysis. Compared with other chronotypes, the participants with evening chronotype had higher risk to suffering from various kinds of pain (OR = 1.54, 95%CI = 1.33-1.78, p < 0.0001), including headache (OR = 1.32, 95%CI = 1.09-1.60, p = 0.009), back pain (OR = 1.44, 95%CI = 1.15-1.79, p < 0.0001) and musculoskeletal (MSK) pain (OR = 1.78, 95%CI = 1.31-2.41, p = 0.0009).

CONCLUSION: There is a connection between sleep chronotype and various types of pain, specifically a significant overall average association between evening chronotype and an increased risk of pain.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251116818.

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Sleep chronotype and its association with coexisting pain outcomes: a systematic review and meta-analysis

Abstract

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