Objective and subjective assessment of sleep in adolescents with chronic pain compared to healthy adolescents.
OBJECTIVE
The purpose of this study was to compare sleep of adolescents with chronic pain and healthy adolescents using both subjective and objective sleep assessments, and to identify correlates of poor sleep.


METHODS
Forty adolescents (n=20 with chronic pain and n=20 healthy adolescents), aged 12 to 17 years (72.5% female) participated. Adolescents completed self-report measures of pain, sleep quality and hygiene, presleep arousal/worry, and depressive symptoms. Sleep patterns were assessed over 7 consecutive days using an actigraph, a motion-monitoring device detecting sleep-wake patterns by measuring activity levels. Total sleep time, sleep efficiency, wake time, and wake bouts were derived from the actigraph and aggregated for analysis.


RESULTS
Compared with healthy peers, adolescents with chronic pain demonstrated similar total sleep time as healthy adolescents, but significantly poorer sleep. In particular, adolescents with chronic pain subjectively reported poorer sleep quality and increased insomnia symptoms, and demonstrated lower actigraphic sleep efficiency and more wake bouts compared with their healthy peers. Depressive symptoms and worry at bedtime were significant predictors of subjectively reported sleep quality but not of actigraphic sleep.


CONCLUSIONS
Adolescents with chronic pain evidenced poorer sleep quality, increased insomnia symptoms, and less efficient sleep with more wake bouts in comparison with healthy adolescents, findings that require replication in a larger sample. Assessment and management of sleep disturbances is an important aspect of care for children and adolescents with chronic pain.
Palermo
Tonya M
TM
Department of Anesthesiology and Peri-Operative Medicine, UHS-2, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA. palermot@ohsu.edu
Toliver-Sokol
Marisol
M
Fonareva
Irina
I
Koh
Jeffrey L
JL
D000293:Adolescent; D001007:Anxiety / Q000209:etiology; D002648:Child; D002908:Chronic Disease; D003863:Depression / Q000209:etiology; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010146:Pain / Q000150:complications*; D017286:Polysomnography / Q000379:methods; D011237:Predictive Value of Tests; D011788:Quality of Life; D018434:Sickness Impact Profile; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis*; D011795:Surveys and Questionnaires