Department of Psychological Studies, The Hong Kong Institute of Education, Hong Kong SAR, China.
Pain Med. 2012 Oct;13(10):1292-303. doi: 10.1111/j.1526-4637.2012.01473.x. Epub 2012 Aug 23.
The comorbidity of chronic pain and sleep disturbances has received increasing research attention in Western clinical pediatric populations; yet, little is known about its sociodemographic and psychological correlates in non-Western community pediatric populations. This study aimed to examine the prevalence of comorbid chronic pain and sleep disturbances and its associated factors in a community sample of Chinese adolescents.
A total of 1,518 adolescents aged from 11 to 19 years participated in this school-based study. Apart from sociodemographic background, participants were assessed on chronic pain, sleep disturbances, depression, perceived stress, and social support. Prevalence of co-occurrence of chronic pain and sleep disturbances was determined. Participants with single symptom were compared with those with symptom co-occurrence on pain characteristics and sleep patterns. Multiple regression model evaluated factors associated with symptom comorbidity.
While the prevalence of chronic pain and sleep disturbances was 11.4% and 25.6%, respectively, the overall prevalence of comorbid chronic pain and sleep disturbances was 19.1% (95% confidence interval: 16.9, 21.4). Fully adjusted stepwise regression analysis identified being female, more depressive symptoms, and higher perceived stress to be significantly associated with comorbid symptoms. Adolescents with both symptoms reported significantly more pain sites, higher worst pain, and higher pain-associated interference than those reported chronic pain only. Participants with comorbid symptoms also had poor subjective sleep quality, greater sleep disturbances, and more daytime dysfunction than those reported sleep disturbances only.
Our data offered preliminary evidence that comorbid chronic pain and sleep disturbances occurred among about one-fifth in the present sample of Chinese community adolescents. Future studies should examine whether the two symptoms interact with each other in affecting the physical, mental, and cognitive development of adolescents.
慢性疼痛和睡眠障碍的共病在西方临床儿科人群中受到越来越多的研究关注；然而，在非西方社区儿科人群中，其社会人口学和心理相关因素知之甚少。本研究旨在调查社区青少年中慢性疼痛和睡眠障碍共病的患病率及其相关因素。
共有 1518 名 11 至 19 岁的青少年参与了这项基于学校的研究。除了社会人口统计学背景外，还评估了参与者的慢性疼痛、睡眠障碍、抑郁、感知压力和社会支持情况。确定慢性疼痛和睡眠障碍共病的发生率。将具有单一症状的参与者与具有症状共病的参与者进行比较，比较疼痛特征和睡眠模式。多元回归模型评估与症状共病相关的因素。
慢性疼痛和睡眠障碍的患病率分别为 11.4%和 25.6%，但慢性疼痛和睡眠障碍的总患病率为 19.1%（95%置信区间：16.9，21.4）。完全调整的逐步回归分析发现，女性、更多的抑郁症状和更高的感知压力与共病症状显著相关。同时患有两种症状的青少年报告的疼痛部位明显更多、最严重疼痛程度更高、疼痛相关干扰更大，这些均高于仅报告慢性疼痛的青少年。同时患有共病症状的参与者的主观睡眠质量较差、睡眠障碍更多、白天功能障碍更多，这些均高于仅报告睡眠障碍的参与者。
我们的数据初步表明，在本研究中，约五分之一的中国社区青少年同时患有慢性疼痛和睡眠障碍。未来的研究应检查这两种症状是否相互作用，从而影响青少年的身体、心理和认知发展。
