Longitudinal Course and Impact of Insomnia Symptoms in Adolescents With and Without Chronic Pain

Abstract

and Perspective This study aimed to: 1) examine trajectories of insomnia symptoms in adolescents with chronic pain compared to their healthy peers, 2) evaluate psychological and behavioral risk factors for longitudinal insomnia symptoms, and 3) evaluate insomnia as a predictor of quality of life, activity limitations, and healthcare utilization over 12 months. Participants included 61 adolescents with chronic pain and 60 youth without chronic pain (12–18 years; 72% female). Questionnaires were completed at enrollment, 6-months, and 12-months, and assessed pain intensity, insomnia symptoms, sleep hygiene, pre-sleep arousal, depression, pubertal status, activity limitations, quality of life, and healthcare utilization. Insomnia symptoms persisted for both groups, and remained higher at all time points for youth with chronic pain. GEE modeling identified three risk factors for longitudinal insomnia symptoms: having chronic pain, poorer sleep hygiene, and higher depressive symptoms. Insomnia symptoms also predicted poorer quality of life over time, and were associated with more frequent healthcare utilization. Findings suggest that sleep problems are persistent and associated with negative impact for youth with chronic pain. Treatment of insomnia symptoms in youth with chronic pain may lead to improvements in quality of life and reductions in healthcare costs. Perspective Insomnia symptoms are persistent over a 12 month period and are associated with negative impact for youth with chronic pain. These findings suggest that treatment of insomnia symptoms in youth with chronic pain may lead to improvements in quality of life and reductions in healthcare costs.

Porównanie dożylnego i podskórnego podawania insulin na intensywność bólu neuropatycznego u chorych na cukrzycę

“…Before the study onset 76% of patients from the study group and 71% of patients from the control group reported significant sleep disturbances, scoring more than 10 points on the AIS scale. Numerous studies emphasise the widespread problem of sleep disturbances, in particular in patients with chronic somatic disorders [16]. Patients with painful sensorimotor polyneuropathy very often complain of sleep disturbances, which have been confirmed in the presented study.…”

Barriers and Facilitators of Evidence-Based Practice in Pediatric Behavioral Sleep Care: Qualitative Analysis of the Perspectives of Health Professionals

“…These may include financial analyses of the costs and benefits of addressing sleep in its own right and as part of the treatment of other health and mental health problems. While the implementation of sleep-related training programs would represent an economic investment, there is growing evidence that, given the profound impact of sleep on health and functioning, not treating sleep presents a substantial economic burden to the healthcare system (Daley et al, 2009;Kapur et al, 2002;Palermo, Law, Churchill, & Walker, 2012).…”

Examination of the Factor Structure of the Adolescent Sleep–Wake Scale (ASWS)

“…Participants were recruited from a variety of sources, including referrals from pediatric medical subspecialties, a health maintenance organization pharmacy database, ongoing psychological intervention trials, a hospital trauma registry, and community advertisements. Information regarding recruitment for several of these studies has been previously published (Holley et al, 2013; Law, Dufton, & Palermo, 2012; Murray et al, 2012; Palermo, Law, Churchill, & Walker, 2012; Palermo et al, 2011). …”