Multivariable logistic regression showed that severe pain (VAS ≥ 9) and diurnal periodicity during the daytime were significant predictors of sick leave after adjusting for age, onset age of CH, sex, PHQ-9, GAD-7, and PSS-4 scores; and cluster year (Additional file 1: Table S1). Here, GAD1 is linked to cyclic hematopoiesis.