|
|
|
« Back
Adolescents with Chronic Pain Experience Sleep Difficulties
|
Posted on: 11/28/2007
|
Adolescence is a time when sleep patterns can be greatly affected due to the many physiological and social changes that take place during this period. However, adolescents who experience chronic pain have more problems with insomnia and poorer quality sleep than those without pain, say researchers of a recent study.
The authors of this study built on previous research and examined sleep issues among adolescents who have chronic pain. The authors hypothesized that this target group had reduced total sleep time, increased depressive symptoms, and higher levels of presleep arousal and worry.
Forty subjects, aged 12 to 17 years, participated in the study, 20 were controls who did not have any pain issues. The subjects' parents completed demographic information forms and the researchers obtained through records, the patients' histories regarding diagnosis, pain, and pain management. The subjects completed several questionnaires. Sleep quality was assessed by The Adolescent Sleep Wake Scale (ASWS) that scored sleep quality from 1 to 6, with "1" for always and "6" for never. This questionnaire assessed going to bed, falling asleep, staying asleep, going back to sleep, and waking. Sleep hygiene (routines before sleeping and the environment) was assessed by the Adolescent Sleep Hygiene Scale (ASHS). This questionnaire reviewed different sleeping habits, ranging from eating and drinking before bed or physical activities to the amount of light in the bedroom during the sleep period.
Using the Visual Analog Scale (VAS), the subjects rated their pain; "0" meant no pain and "10" was for the worst pain possible. Using the Likert scale, the subjects rated how often they experienced pain. Subjects also completed questionnaires before the study about the quality, location, frequency, and intensity of the pain. Worry and arousal at bedtime was assessed with the Pre-Sleep Arousal Scale (PAS), which uses a scale of 1 to 5, with "1" being for "not at all" and "5" being for "extremely." Finally depressive symptoms were assessed with the major depressive disorder subscale of the Revised Child Anxiety and Depression Scale (RCADS). This scale rated from 1 to 4 the frequency of depressive symptoms.
Actual sleep and wakefulness were measured with a wrist-watch-like instrument called the Actiwatch-AW64 system (MiniMitter, Bend OR). This device is worn for 7 consecutive days to detect sleep patterns. A sleep log was also kept by the study subjects.
When analyzing the study findings, the researchers found that 70 percent of the subjects in the pain group reported daily pain in the moderate to severe range. To relieve the pain from chronic headache (40 percent), abdominal pain (10 percent), pain elsewhere in the body (40 percent), or complex regional pain syndrome (10 percent), the patients used either over-the-counter or prescription medications. There did not appear to be any significant differences in subjective sleep quality, sleep hygiene, sleep time, sleep efficiency, wake time, or wake bouts between subjects who took prescription medications and those who did not.
Subjects in the pain group had lower sleep efficacy than the control group. Both groups spent the same amount of time in bed, but those with pain woke up more frequently. Estimated sleep time and wake after sleep onset seemed to be the same between the two groups. When asked about sleep quality, those with chronic pain ranked their sleep quality significantly lower than their control peer. Bouts of insomnia were reported more often in the pain group. Sleep hygiene was found to be similar between the groups. The association between pain, depressive symptoms, presleep arousal and worry, and sleep variables showed a moderate association between more intense pain and more wake times. Those with pain had greater scores in presleep worry and depression.
The authors point out that their study has some limitations, including the small sample size and the fact that the adolescents were receiving treatment for their pain. Nonetheless, the authors say their findings that over half of adolescents who experience chronic pain also report insomnia, compared with only 10 percent of adolescents without chronic pain, indicates that there are clinical implications for the assessment and management of sleep issues among this patient group.
|
References:
Tonya M. Palermo, PhD, et al. Objective and Subjective Assessment of Sleep in Adolescents with Chronic Pain Compared to Healthy Adolescents. In Clinical Journal of Pain. November/December 2007. Vol. 23. No. 9. Pp. 799-803.
|
|
|
« Back
|
|
|
|
*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
 | All content provided by eORTHOPOD® is a registered trademark of Mosaic Medical Group, L.L.C.. Content is the sole property of Mosaic Medical Group, LLC and used herein by permission. |
|
