title: Subjective sleep disturbances in adolescents with chronic pain: relationship to daily functioning and quality of life.
abstract: The purpose of this study was to examine the relationship between pain symptoms, daily functioning, health-related quality of life (HRQOL), and subjectively reported sleep disturbances in adolescents with chronic pain. Depressive symptoms were tested as a general risk factor for increased sleep problems. During routine subspecialty clinic visits, 86 adolescents (mean age, 14.75 years; 67% female) diagnosed with chronic headaches, juvenile idiopathic arthritis, or sickle cell disease completed measures to assess pain, sleep disturbances, functional disability, depression, and HRQOL. Across pain diagnoses, adolescents experienced similar sleep patterns and sleep behaviors with the exception of daytime sleepiness, which was higher in adolescents with headache compared to adolescents with sickle cell disease. Bivariate correlations showed low relationships between pain and sleep and moderate to high relationships between depressive symptoms, daily functioning, HRQOL, and sleep. In multivariate analyses, as hypothesized, depressive symptoms were predictive of the severity of sleep disturbances after controlling for the effect of all other demographic, pain, and functional impact variables. Results suggest that a relationship between the experience of recurrent and chronic pain and sleep disturbances exists for adolescents, and these sleep disturbances are linked to mood disturbances and reductions in daily functioning and quality of life. Sleep disturbances have been described in adult patients with chronic pain, but little is known about sleep in adolescents with chronic pain. This study examined the complex interrelationship between sleep, pain, mood, functioning, and HRQOL. Findings suggest that mood is strongly related to sleep and might share common pathophysiologic or behavioral origins in adolescents with chronic pain.
authors.affiliation: Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. palermot@ohsu.edu
authors.forename: Tonya M
authors.initials: TM
authors.lastname: Palermo
authors.forename: Raechel
authors.initials: R
authors.lastname: Kiska
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000339:Affect; D002908:Chronic Disease; D003863:Depression / Q000150:complications / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000150:complications* / Q000523:psychology; D011237:Predictive Value of Tests; D011788:Quality of Life; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000503:physiopathology* / Q000523:psychology