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Sleep disturbance is associated with chronic pain. Central sensitization (CS), defined as the amplification of neural signaling within the central nervous system that results in pain hypersensitivity, may be one pathway through which sleep disturbance contributes to chronic pain. Sleep disturbance and CS are both associated with maladaptive body awareness, characterized by increased hypervigilance and catastrophizing in response to body sensations. Impaired sleep, increases maladaptive body awareness, which then contributes to CS. Less is known about the relationship between quality sleep, adaptive body awareness (i.e., increased attention to and awareness of body sensations, devoid of negative evaluations of sensations), and CS. Primary aims were to evaluate mediational pathways through which (1) sleep disturbance might be related to increased pain intensity via CS-related symptoms and (2) quality sleep might be related to lower CS-related symptoms via adaptive body awareness. Methods In a cross-sectional study, online surveys were administrated to 301 individuals with chronic pain. Pearson’s correlations characterized overall relationship between self-reported sleep quality (PROMIS-Sleep), adaptive body awareness (Multidimensional Assessment of Interoceptive Awareness; MAIA-2), and CS-related symptoms (Central Sensitization Inventory; CSI). Two path analyses using PROCESS were conducted. Results Results revealed that a one-unit increase in sleep disturbance was associated with a 1.7 unit increase in pain intensity, which was partially explained by CS-related symptoms [point estimate=.16; 95% bootstrap confident intervals (CI)=0.10 to 0.22]. In a separate path analysis, a one-unit decrease in sleep disturbance was associated with a 3.5 unit decrease in CS-related symptoms, which was partially explained via adaptive body awareness [point estimate=.25; 95% CI=0.03 to 0.52]. Conclusion Novel findings provide greater understanding into pathways through which sleep might contribute to chronic pain. Results support longitudinal studies to explore effects of sleep and adaptive body awareness on self-reported symptoms and biological markers of CS within chronic pain populations. Support (if any):

790 Adaptive Body Awareness Mediates the Relationship between Quality of Sleep and Symptoms of Central Sensitization