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47 [1.38-1.58], P = 4.12x10 -28). Manifested pain had a small effect on increased risk for insomnia (OR [95% CI] = 1.04 [1.01-1.07], P 0.05). Results were consistent in sensitivity analyses. Our findings support a bidirectional causal relationship between insomnia and pain. These data support further clinical investigation into the utility of insomnia treatment as a strategy for pain management and vice versa. Our findings support a bidirectional causal relationship between insomnia and pain. These data support further clinical in
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