title: Sleep, well-being, and psychological symptoms in adults with pediatric-onset spinal cord injury.
abstract: OBJECTIVE
  To examine the prevalence of poor sleep quality in adults with pediatric-onset spinal cord injury (SCI) and to assess the clinical correlates.
  
  
  METHODS
  Participants completed interviews that included demographic information and standardized measures of sleep (Pittsburgh Sleep Quality Index), physical (12-item Short-Form Health Survey, Version 2), mental (Beck Anxiety Inventory and Patient Health Questionnaire), and psychosocial well-being (Satisfaction With Life Scale). The study included 177 individuals between the ages of 19 and 50 years (M = 33.5 years, SD = 7.1) who sustained a, SCI prior to age 19 (M = 13.5 years, SD = 4.6) and had been injured for at least 1 year (M = 19.5 years, SD = 8. 2). Participants were recruited from 1 of 3 pediatric SCI programs in the United States and were predominantly male (62%) and White (84%).
  
  
  RESULTS
  Sleep difficulties were fairly common, with half of participants self-reporting poor sleep quality within the last month (n = 91 [51.4%]). Both increased age (r = .20, p = .008) and tetraplegia, F(1, 175) = 6.62, p = .011, were significantly associated with poor sleep. Activity-interfering pain (r = .57, p < .001) and general health (r = .37, p < .001) were also strongly associated with poor sleep. Even after accounting for age, injury level, and pain as control variables, sleep quality explained a small, but significant, portion of the variance in depression (R2 = .06, p < .001) and anxiety (R2 = .04, p = .005), but not life satisfaction (R2 = .02, p = .075).
  
  
  CONCLUSIONS
  These results suggest that adults with pediatric-onset SCI report more sleep difficulties than the standardization sample and that sleep is significantly associated with physical and psychological functioning. Consequently, better measures to detect and treat sleep problems among those with pediatric-onset SCI are recommended.
authors.affiliation: Department of Psychology.
authors.forename: Alicia M
authors.initials: AM
authors.lastname: January
authors.affiliation: Department of Psychology.
authors.forename: Kathy
authors.initials: K
authors.lastname: Zebracki
authors.affiliation: Department of Clinical Research.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Chlan
authors.affiliation: Department of Pediatrics.
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Vogel
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D055815:Young Adult