Sleep chronotype and its association with coexisting pain outcomes: a systematic review and meta-analysis
Abstract
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 I2 < 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.
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.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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