title: The comorbidity of chronic pain and sleep disturbances in a community adolescent sample: prevalence and association with sociodemographic and psychosocial factors.
abstract: OBJECTIVE
  The comorbidity of chronic pain and sleep disturbances has received increasing research attention in Western clinical pediatric populations; yet, little is known about its sociodemographic and psychological correlates in non-Western community pediatric populations. This study aimed to examine the prevalence of comorbid chronic pain and sleep disturbances and its associated factors in a community sample of Chinese adolescents.
  
  
  METHODS
  A total of 1,518 adolescents aged from 11 to 19 years participated in this school-based study. Apart from sociodemographic background, participants were assessed on chronic pain, sleep disturbances, depression, perceived stress, and social support. Prevalence of co-occurrence of chronic pain and sleep disturbances was determined. Participants with single symptom were compared with those with symptom co-occurrence on pain characteristics and sleep patterns. Multiple regression model evaluated factors associated with symptom comorbidity.
  
  
  RESULTS
  While the prevalence of chronic pain and sleep disturbances was 11.4% and 25.6%, respectively, the overall prevalence of comorbid chronic pain and sleep disturbances was 19.1% (95% confidence interval: 16.9, 21.4). Fully adjusted stepwise regression analysis identified being female, more depressive symptoms, and higher perceived stress to be significantly associated with comorbid symptoms. Adolescents with both symptoms reported significantly more pain sites, higher worst pain, and higher pain-associated interference than those reported chronic pain only. Participants with comorbid symptoms also had poor subjective sleep quality, greater sleep disturbances, and more daytime dysfunction than those reported sleep disturbances only.
  
  
  CONCLUSIONS
  Our data offered preliminary evidence that comorbid chronic pain and sleep disturbances occurred among about one-fifth in the present sample of Chinese community adolescents. Future studies should examine whether the two symptoms interact with each other in affecting the physical, mental, and cognitive development of adolescents.
authors.affiliation: Department of Psychological Studies, The Hong Kong Institute of Education, Hong Kong SAR, China.
authors.forename: Yat-Fan
authors.initials: YF
authors.lastname: Siu
authors.forename: Simon
authors.initials: S
authors.lastname: Chan
authors.forename: Ka-Man
authors.initials: KM
authors.lastname: Wong
authors.forename: Wing-Sze
authors.initials: WS
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D044466:Asian People; D002648:Child; D059350:Chronic Pain / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011584:Psychology; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult