Pediatric sleep and pain: etiologies, consequences, and clinical considerations

Morris, Erin E.; Howell, Michael J.; Pickup, Elizabeth; Iber, Conrad; Wang, Sonya

doi:10.5664/jcsm.10008

Cited by 5 publications

(3 citation statements)

References 97 publications

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“…Our study extends previous findings by showing how pain, psychological, and sleep disturbance symptoms may evolve and worsen simultaneously over time for many youths. Conflicting data support temporal directions from internalizing symptoms toward increasing or persistent pain, 8,10,17 from sleep disturbance toward persistent pain and mental health symptoms, [43][44][45] and the reverse, from chronic pain to internalizing symptoms. 17,19,46 In contrast, our findings suggest concurrent emergence of symptoms for many children.…”

Section: Discussionmentioning

confidence: 99%

Associations of Co-occurring Symptom Trajectories With Sex, Race, Ethnicity, and Health Care Utilization in Children

et al. 2023

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ImportanceCo-occurring physical and psychological symptoms during childhood and early adolescence may increase risk of symptom persistence into adulthood.ObjectiveTo describe co-occurring pain, psychological, and sleep disturbance symptom (pain-PSS) trajectories in a diverse cohort of children and the association of symptom trajectory with health care utilization.Design, Setting, and ParticipantsThis cohort study was a secondary analysis of longitudinal data from the Adolescent Brain Cognitive Development (ABCD) Study, collected between 2016 and 2022 at 21 research sites across the US. Participants included children with 2 to 4 complete annual symptom assessments. Data were analyzed from November 2022 to March 2023.Main Outcomes and MeasuresFour-year symptom trajectories were derived from multivariate latent growth curve analyses. Pain-PSS scores, including depression and anxiety, were measured using subscales from the Child Behavior Checklist and the Sleep Disturbance Scale of Childhood. Nonroutine medical care and mental health care utilization were measured using medical history and Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) items.ResultsA total of 11 473 children (6018 [52.5%] male; mean [SD] age at baseline, 9.91 [0.63] years) were included in analyses. Four no pain-PSS and 5 pain-PSS trajectories were supported with good or excellent model fit (predicted probabilities, 0.87-0.96). Most children (9327 [81.3%]) had asymptomatic or low, intermittent, or single symptom trajectories. Approximately 1 in 5 children (2146 [18.7%]) had moderate to high co-occurring symptom trajectories that persisted or worsened. Compared with White children, there was a lower relative risk of having moderate to high co-occurring symptom trajectories among Black children (adjusted relative risk ratio [aRRR] range, 0.15-0.38), Hispanic children (aRRR range, 0.58-0.67), and children who identified as another race (including American Indian, Asian, Native Hawaiian, and other Pacific Islader; aRRR range, 0.43-0.59). Less than half of children with moderate to high co-occurring symptom trajectories used nonroutine health care, despite higher utilization compared with asymptomatic children (nonroutine medical care: adjusted odds ratio [aOR], 2.43 [95% CI, 1.97-2.99]; mental health services: aOR, 26.84 [95% CI, 17.89-40.29]). Black children were less likely to report nonroutine medical care (aOR, 0.61 [95% CI, 0.52-0.71]) or mental health care (aOR, 0.68 [95% CI, 0.54-0.87]) than White children, while Hispanic children were less likely to have used mental health care (aOR, 0.59 [95% CI, 0.47-0.73]) than non-Hispanic children. Lower household income was associated with lower odds of nonroutine medical care (aOR, 0.87 [95% CI, 0.77-0.99]) but not mental health care.Conclusions and RelevanceThese findings suggest there is a need for innovative and equitable intervention approaches to decrease the potential for symptom persistence during adolescence.

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Section: Discussionmentioning

confidence: 99%

Associations of Co-occurring Symptom Trajectories With Sex, Race, Ethnicity, and Health Care Utilization in Children

et al. 2023

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“…54 Moreover, VR has the potential to indirectly reduce a child's experience of pain by reducing the deleterious effects of sleep deprivation on subjective ratings of pain, their pain threshold and activation within their somatosensory cortex. 55,56…”

Section: Discussionmentioning

confidence: 99%

Extended Reality Use in Paediatric Intensive Care: A Scoping Review

Goldsworthy

Chawla

Baumann

et al. 2023

J Intensive Care Med

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Background: Extended reality (XR) technology such as virtual and augmented reality is increasingly being utilised in paediatric medicine due to its role in medical education and reported positive impacts on outcomes including pain, anxiety, and sleep. To the author’s knowledge, no previous reviews investigating the use of XR in paediatric intensive care have been undertaken. Objectives: To scope the use of XR in paediatric intensive care, and assess its barriers to adoption, including safety considerations, cleaning and infection control. Eligibility criteria: All articles of any methodological design discussing the use of XR within paediatric intensive and critical care were included. Sources of evidence: Four databases (EMBASE, CINAHL, PsychInfo, PubMed) and Google Scholar were searched without any limitations on publication year. Charting methods: Data was extracted into Microsoft Excel by two authors independently (AG & SF) and cross-checked for completeness. Results: One hundred and eighty-eight articles were originally identified. Following the application of eligibility criteria 16 articles utilising XR in clinical interventions (n = 7) and medical education (n = 9) were included. Articles utilised VR and AR for highly variable purposes within both medical education (eg disaster preparedness, intubation) and clinical interventions (eg decrease pain, nausea, anxiety and improve Glasgow Coma Scale). Conclusions: While research into the use of XR in paediatric intensive care is still in its infancy it has increased dramatically over the past 5 years within two key areas. Firstly, in healthcare education, to assist in the acquisition of PICU-specific knowledge and practice of skills such as intubation of difficult airways. Secondly, studies have evaluated and demonstrated that with appropriate use, VR appears to be a safe and feasible intervention to decrease pain and anxiety in PICU patients.

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“…B. [4], und es ist anzuraten, schon im Baby-und Kleinkindalter auf einen regelmäßigen und guten Schlaf zu achten und diesen spätestens bei Auftreten von Schmerzen zu verbessern [15].…”

Section: Psychosoziale Einflussfaktorenunclassified

Psychosoziale Einflussfaktoren auf die Schmerzchronifizierung bei jungen Menschen

Höfel¹,

Aigner²,

Rummel-Siebert³

et al. 2022

Arthritis und Rheuma

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ZUSAMMENFASSUNGChronische Schmerzen bei Kindern und Jugendlichen werden oft in Zusammenhang mit Angst, Depression und Verhaltensauffälligkeiten gebracht, zugleich begünstigen diese psychischen Auffälligkeiten eine Chronifizierung. Lebensqualität, Angst-Vermeidungs-Tendenzen, elterliches Verhalten und sozioökonomischer Status modulieren ebenfalls Prozesse der Schmerzchronifizierung. Darüber hinaus müssen Schlafverhalten, operative/invasive Eingriffe, spezielle Schmerzarten und -orte und frühkindliche Schmerzerfahrungen als mögliche Prädiktoren für chronische Schmerzen rechtzeitig in Erwägung gezogen werden. Im klinischen Alltag sollten all diese Faktoren in Anamnese, Edukation und Therapieverlauf einbezogen werden. Ein rechtzeitiges Erkennen und Therapieren psychischer und sozialer Belastungen kann die Gefahr der Chronifizierung von Schmerzen reduzieren.

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Pediatric sleep and pain: etiologies, consequences, and clinical considerations

Cited by 5 publications

References 97 publications

Associations of Co-occurring Symptom Trajectories With Sex, Race, Ethnicity, and Health Care Utilization in Children

Associations of Co-occurring Symptom Trajectories With Sex, Race, Ethnicity, and Health Care Utilization in Children

Extended Reality Use in Paediatric Intensive Care: A Scoping Review

Psychosoziale Einflussfaktoren auf die Schmerzchronifizierung bei jungen Menschen

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