Health
Chronic Back Pain in Older Men Linked to Sleep Problems, Study Finds
Chronic back pain in men over 65 may increase the risk of sleep problems later in life, according to a new study from Penn State University. Researchers found that men experiencing persistent back pain were more likely to develop poor sleep over time, with the relationship running in one direction: back pain first, followed by sleep disturbances.
“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 Penn State and lead author of the study. “We studied data collected over several years to understand whether poor sleep could predict back pain or if back pain could predict poor sleep, and we found it was the latter.”
The study, published in Innovation in Aging, used data from the long-running Osteoporotic Fractures in Men study, which tracks older men to better understand aging and the development of chronic conditions. Researchers analyzed information from 1,055 men who completed clinical sleep assessments at least six years apart and reported the severity and frequency of back pain every four months between assessments.
Comparing participants’ sleep data across the two assessments, the team found that back pain predicted a 12 to 25 percent increase in sleep problems over six years. The study looked beyond total hours of sleep, examining irregular sleep schedules, difficulty staying asleep, and excessive daytime sleepiness.
The research also explored the possibility of a two-way relationship between back pain and sleep, but found that sleep problems did not predict future back pain. Researchers caution that the findings are based on observational data from primarily white, older men, and may not apply equally to women or more diverse populations.
Lee said the study highlights the importance of addressing back pain in older adults. “If caregivers or loved ones see back pain issues, this can be a warning sign,” she said. Effective management of pain, she added, may help prevent future sleep problems and reduce the risk of related health issues such as memory decline, depression, anxiety, and falls.
Quality sleep in older adults is strongly associated with better physical health, slower cognitive decline, and lower mortality risk. Recent research indicates that people with chronic insomnia—difficulty sleeping at least three nights per week for three months or more—are about 40 percent more likely to develop dementia or mild cognitive impairment than those who sleep normally.
The study’s findings suggest that addressing chronic back pain could be a key step in improving sleep quality and long-term health outcomes for older men. Clinicians and caregivers are encouraged to monitor back pain carefully and consider interventions that may reduce its impact on sleep.
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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026
Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.
“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.
Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.
At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.
The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.
A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.
The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.
Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.
International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.
If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.
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