Department of Psychology, University of Calgary and Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
Department of Anesthesia, University of Calgary, Calgary, AB, Canada.
J Pain. 2018 Jan;19(1):67-75. doi: 10.1016/j.jpain.2017.09.002. Epub 2017 Sep 27.
Symptoms of post-traumatic stress disorder (PTSS) and chronic pain have been shown to co-occur at high rates in adolescents and this co-occurrence is linked to worse pain and quality of life. Sleep disturbance has been posited as a mechanism underlying this co-occurrence in conceptual models of mutual maintenance. This study examined the mediating role of sleep in the relationship between PTSS and pain in youth (aged 10-17 years) with chronic pain. Ninety-seven participants completed measures of PTSS, pain (intensity and interference), anxiety symptoms, and sleep quality, in addition to demographic characteristics. Mediation models were conducted. Findings revealed that, over and above the influence of associated demographic characteristics (age, race) and anxiety symptoms, sleep quality partially mediated the relationships between PTSS and pain intensity and interference for youth with chronic pain. Specifically, higher levels of PTSS was linked to higher levels of pain intensity and pain interference, and these relationships were partially explained by poor sleep quality. Findings highlight the potential mechanistic role of sleep in explaining the co-occurrence of chronic pain and PTSS and suggest sleep might be an important target in future interventions.
Consistent with the pediatric model of mutual maintenance in PTSS and chronic pain, poor sleep quality was found to underlie this co-occurrence in youth.
创伤后应激障碍 (PTSS) 和慢性疼痛的症状已被证明在青少年中以高频率同时出现，这种同时出现与更严重的疼痛和生活质量有关。睡眠障碍已被认为是相互维持的概念模型中这种同时出现的潜在机制。本研究考察了睡眠在青少年（年龄 10-17 岁）慢性疼痛中 PTSD 和疼痛之间关系中的中介作用。97 名参与者完成了创伤后应激障碍、疼痛（强度和干扰）、焦虑症状和睡眠质量的测量，以及人口统计学特征。进行了中介模型分析。研究结果表明，除了相关人口统计学特征（年龄、种族）和焦虑症状的影响外，睡眠质量部分中介了慢性疼痛青少年中 PTSD 与疼痛强度和干扰之间的关系。具体而言，较高水平的 PTSD 与较高水平的疼痛强度和疼痛干扰有关，而这些关系部分是由睡眠质量差解释的。研究结果强调了睡眠在解释慢性疼痛和 PTSD 同时出现的潜在机制作用，并表明睡眠可能是未来干预的一个重要目标。
与 PTSD 和慢性疼痛的儿科相互维持模型一致，研究发现睡眠质量差是青少年中这种同时出现的基础。
