CPAP adherence appears to be associated with positive changes in OSAS-specific QoL domains. It will be important for future research and clinical work to examine strategies for improving CPAP adherence in youth with OSAS.

Background Racial differences in endogenous pain facilitatory processes have been previously reported. Evidence suggests that psychological and behavioral factors, including depressive symptoms and sleep, can alter endogenous pain facilitatory processes. Whether depressive symptoms and sleep might help explain racial differences in endogenous pain facilitatory processes has yet to be determined. Purpose This observational, microlongitudinal study examined whether depressive symptoms and sleep were sequential mediators of racial differences in endogenous pain facilitatory processes. Methods A total of 50 (26 African American and 24 non-Hispanic White) community-dwelling adults without chronic pain (mean 49.04 years; range 21–77) completed the Center for Epidemiological Studies Depression Scale prior to seven consecutive nights of sleep monitoring with actigraphy in the home environment. Participants subsequently returned to the laboratory for assessment of endogenous pain facilitation using a mechanical temporal summation protocol. Results Findings revealed greater depressive symptoms, poorer sleep efficiency, and greater temporal summation of mechanical pain in African Americans compared to non-Hispanic Whites. In a sequential mediation model, greater depressive symptoms predicted poorer sleep efficiency (t = −2.55, p = .014), and poorer sleep efficiency predicted enhanced temporal summation of mechanical pain (t = −4.11, p < .001), particularly for African Americans. Conclusions This study underscores the importance of examining the contribution of psychological and behavioral factors when addressing racial differences in pain processing. Additionally, it lends support for the deleterious impact of depressive symptoms on sleep efficiency, suggesting that both sequentially mediate racial differences in endogenous pain facilitation.

The clinical symptoms of EoE, specifically epigastric pain, were found to be predictive of the youth's HRQoL. Targeted interventions to help youth with EoE better manage their specific symptom experiences could ultimately improve HRQoL.

With greater understanding of the associations among sleep, pain, internalizing symptoms, and HRQoL in children with EoE may come enhanced therapies that substantially improve the quality of their health care.

WHAT'S KNOWN ON THIS SUBJECT:For adults, sleep deprivation before or after immunization is associated with decreased antigen-specific antibody formation, but little is known about infant sleep before and after immunization or the effects of prophylactic acetaminophen treatment on infant sleep. WHAT THIS STUDY ADDS:Infants demonstrated increased sleep duration in the 24 hours after immunization, particularly if they were immunized after 1:30 PM and had elevated temperatures. Acetaminophen use was associated with smaller increases in sleep duration but not when other factors were controlled. abstract OBJECTIVE: To determine the effects of acetaminophen and axillary temperature responses on infant sleep duration after immunization. METHODS:We conducted a prospective, randomized controlled trial to compare the sleep of 70 infants monitored by using ankle actigraphy for 24 hours before and after their first immunization series at ϳ2 months of age. Mothers of infants in the control group received standard care instructions from their infants' health care provider, and mothers of infants in the intervention group were provided with predosed acetaminophen and instructed to administer a dose 30 minutes before the scheduled immunization and every 4 hours thereafter, for a total of 5 doses. Infant age and birth weight and immunization factors, such as acetaminophen use and timing of administration, were evaluated for changes in infant sleep times after immunization. RESULTS:Sleep duration in the first 24 hours after immunization was increased, particularly for infants who received their immunizations after 1:30 PM and for those who experienced elevated temperatures in response to the vaccines. Infants who received acetaminophen at or after immunization had smaller increases in sleep duration than did infants who did not. However, acetaminophen use was not a significant predictor of sleep duration when other factors were controlled. CONCLUSIONS:If further research confirms the relationship between time of day of vaccine administration, increased sleep duration after immunization, and antibody responses, then our findings suggest that afternoon immunizations should be recommended to facilitate increased sleep in the 24 hours after immunization, regardless of acetaminophen administration.