School of Nursing and Department of Pediatrics and Psychology, Dalhousie University, Halifax, Nova Scotia, Canada.
Res Dev Disabil. 2011 Nov-Dec;32(6):2829-40. doi: 10.1016/j.ridd.2011.05.023. Epub 2011 Jun 12.
Both chronic pain and sleep problems are common for children with intellectual and developmental disabilities (IDD). Although one study has revealed a relationship between having a medical condition and sleep problems in this population, the role of pain was not examined independently. Thus, the goal of this study was to clarify the specific role of pain in children's sleep problems. Caregivers of 123 children with IDD (67 male; mean age = 10 years, 7 months (SD = 49.7 months)) completed the Children's Sleep Habits Questionnaire (CHSQ) and provided information about children's pain, function and demographic characteristics. Children were grouped as having: No Pain (86), Treated Pain (21), or Untreated Pain (16). A Multivariate Analysis of Variance (MANOVA) indicated children who had pain had significantly more sleep problems overall (F(16, 222) = 2.2, p = .005), and more Night Wakings (F(2, 118) = 3.1, p = .05), Parasomnias (F(2, 118) = 5.0, p = .009) and Sleep Disordered Breathing (F(2, 118) = 5.1, p = .008) in particular. The pattern of sleep problems varied due to whether the child was taking pain medication. Children with pain also had significantly shorter typical sleep duration (F(2, 112) = 3.5, p = 0.035). The presence of sleep problems did not vary due to functional level or whether children were taking sleep medications. However, parents of children who were taking sleep medications reported that both Bedtime Resistance (F(1, 121) = 5.7, p = .019) and Sleep Duration (F(1, 121) = 6.0, p = .016) were more problematic for them. This data indicates pain disrupts sleep in children with IDD even when it is being managed pharmacologically, suggesting pain treatment may not be effective. These results suggest that pain should be considered during evaluation and management of sleep problems in children with IDD.
慢性疼痛和睡眠问题在智障和发育障碍（ID）儿童中很常见。尽管有一项研究揭示了该人群中存在医疗状况与睡眠问题之间的关系，但并未单独检查疼痛的作用。因此，本研究的目的是阐明疼痛在儿童睡眠问题中的具体作用。123 名智障儿童的照顾者（67 名男性；平均年龄= 10 岁 7 个月（SD=49.7 个月））完成了《儿童睡眠习惯问卷》（CHSQ），并提供了有关儿童疼痛、功能和人口统计学特征的信息。儿童分为无疼痛（86 人）、治疗性疼痛（21 人）和未治疗性疼痛（16 人）。多变量方差分析（MANOVA）表明，有疼痛的儿童总体上睡眠问题更为严重（F（16,222）=2.2，p=0.005），夜间醒来（F（2,118）=3.1，p=0.05）、睡眠障碍（F（2,118）=5.0，p=0.009）和睡眠呼吸障碍（F（2,118）=5.1，p=0.008）的问题更为突出。由于儿童是否服用疼痛药物，睡眠问题的模式也有所不同。有疼痛的儿童的典型睡眠时间也明显缩短（F（2,112）=3.5，p=0.035）。睡眠问题的存在与功能水平或儿童是否服用睡眠药物无关。然而，服用睡眠药物的儿童的父母报告说，入睡时的抗拒（F（1,121）=5.7，p=0.019）和睡眠时间（F（1,121）=6.0，p=0.016）对他们来说更为成问题。这些数据表明，即使在进行药物治疗时，疼痛也会干扰智障儿童的睡眠，这表明疼痛治疗可能无效。这些结果表明，在评估和治疗智障儿童的睡眠问题时，应考虑疼痛因素。
