Chronic sleep restriction during adolescence appears to cause increased consumption of foods with a high glycemic index, particularly desserts/sweets. The chronic sleep restriction common in adolescence may cause changes in dietary behaviors that increase risk of obesity and associated morbidity.

WHAT'S KNOWN ON THIS SUBJECT: Juvenile-onset fibromyalgia (JFM) is a poorly understood chronic pain condition, typically identified in adolescence and accompanied by physical and social impairment and mood difficulties. There are no long-term studies on the prognosis of adolescents with JFM into adulthood. WHAT THIS STUDY ADDS:This prospective study demonstrated that pain and other symptoms persisted into adulthood for .80% of JFM patients, with associated impairments in physical functioning and mood. At follow-up, one-half of the sample met full criteria for adult fibromyalgia. abstractOBJECTIVE: This prospective longitudinal study examined the long-term physical and psychosocial outcomes of adolescents with juvenile-onset fibromyalgia (JFM), compared with healthy control subjects, into early adulthood.METHODS: Adolescent patients with JFM initially seen at a pediatric rheumatology clinic (n = 94) and age-and gender-matched healthy control subjects (n = 33) completed online measures of demographic characteristics, pain, physical functioning, mood symptoms, and health care utilization at ∼6 years' follow-up (mean age: 21 years). A standard in-person tender-point examination was conducted. RESULTS:Patients with JFM had significantly higher pain (P , .001), poorer physical function (P , .001), greater anxiety (P , .001) and depressive symptoms (P , .001), and more medical visits (P , .001) than control subjects. The majority (.80%) of JFM patients continued to experience fibromyalgia symptoms into early adulthood, and 51.1% of the JFM sample met American College of Rheumatology criteria for adult fibromyalgia at follow-up. Patients with JFM were more likely than control subjects to be married and less likely to obtain a college education.CONCLUSIONS: Adolescent patients with JFM have a high likelihood of continued fibromyalgia symptoms into young adulthood. Those who met criteria for fibromyalgia in adulthood exhibited the highest levels of physical and emotional impairment. Emerging differences in educational attainment and marital status were also found in the JFM group. JFM is likely to be a long-term condition for many patients, and this study for the first time describes the wide-ranging impact of JFM on a variety of physical and psychosocial outcomes that seem to diverge from their same-age peers.

Objectives Adolescents with juvenile fibromyalgia (JFM) are typically sedentary despite recommendations for physical exercise, a key component of pain management. Interventions such as cognitive behavioral therapy (CBT) are beneficial but do not improve exercise participation. The objective of this study was to obtain preliminary information about the feasibility, safety, and acceptability of a new intervention - Fibromyalgia Integrative Training for Teens (FIT Teens), which combines CBT with specialized neuromuscular exercise training modified from evidence-based injury prevention protocols. Methods Participants were 17 adolescent females (ages 12–18) with JFM. Of these, 11 completed the 8-week (16-session) FIT Teens program in a small-group format with 3–4 patients per group. Patients provided detailed qualitative feedback via individual semi-structured interviews after treatment. Interview content was coded using thematic analysis. Interventionist feedback about treatment implementation was also obtained. Results The intervention was found to be feasible, well-tolerated, and safe for JFM patients. Barriers to enrollment (50% of those approached) included difficulties with transportation or time conflicts. Treatment completers enjoyed the group format and reported increased self-efficacy, strength, and motivation to exercise. Participants also reported decreased pain and increased energy levels. Feedback from participants and interventionists was incorporated into a final treatment manual to be used in a future trial. Discussion Results of this study provided initial support for the new FIT Teens program. An integrative strategy of combining pain coping skills via CBT enhanced with tailored exercise specifically designed to improve confidence in movement and improving activity participation holds promise in the management of JFM.

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Chronic pain in children is associated with significant negative impact on social, emotional, and school functioning. Previous studies on the impact of pain on children's functioning have primarily used mixed samples of pain conditions or single pain conditions (e.g., headache, abdominal pain) with relatively small sample sizes. As a result, the similarities and differences in the impact of pain in sub-groups of children with chronic pain have not been closely examined. Objectives To compare pain characteristics, quality of life, and emotional functioning among youth with pediatric chronic migraine (CM) and juvenile fibromyalgia (JFM). Methods We combined data obtained during screening of patients for two relatively large intervention studies of youth (ages 10-18) with CM (N = 153) and JFM (N = 151). Measures of pain intensity, quality of life (Pediatric Quality of Life; PedsQL™, child and parent-proxy), depressive symptoms (Children's Depression Inventory; CDI), and anxiety symptoms (Adolescent Symptom Inventory-4 - Anxiety subscale) were completed by youth and their parent. A multivariate analysis of co-variance (MANCOVA) controlling for effects of age and gender was performed to examine differences in quality of life and emotional functioning between the CM and JFM groups. Results Youth with JFM had significantly higher anxiety and depressive symptoms, and lower quality of life in all domains. Among children with CM, overall functioning was higher but school functioning was a specific area of concern. Discussion Results indicate important differences in sub-groups of pediatric pain patients and point to the need for more intensive multidisciplinary intervention for JFM patients.