Pavlova Maria, Ference Jennifer, Hancock Megan, Noel Melanie
Department of Psychology, University of Calgary, Calgary, AB, Canada.
Alberta Children's Hospital, Calgary, AB, Canada.
Pain Res Manag. 2017;2017:1586921. doi: 10.1155/2017/1586921. Epub 2017 Nov 16.
Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populations with pain-related chronic illnesses suggest that internalizing mental health symptoms may mediate the sleep-pain relationship; however, this has not been examined in youth with primary pain disorders.
To examine whether anxiety and depressive symptoms mediated relationships between sleep quality and pain outcomes among youth with chronic pain.
Participants included 147 youth (66.7% female) aged 8-18 years who were referred to a tertiary-level chronic pain program. At intake, the youth completed psychometrically sound measures of sleep quality, pain intensity, pain interference, and anxiety and depressive symptoms.
As hypothesized, poor sleep quality was associated with increased pain intensity and pain interference, and anxiety and depressive symptoms mediated these sleep-pain relationships.
For youth with chronic pain, poor sleep quality may worsen pain through alterations in mood and anxiety; however, prospective research using objective measures is needed. Future research should examine whether targeting sleep and internalizing mental health symptoms in treatments improve pain outcomes in these youth.
儿童慢性疼痛通常在青春期出现，并与内化性心理健康问题和睡眠障碍同时发生。新出现的证据表明，睡眠问题可能先于慢性疼痛以及焦虑和抑郁的发作。在患有与疼痛相关的慢性疾病的儿科人群中进行的研究表明，内化性心理健康症状可能介导睡眠与疼痛的关系；然而，这在患有原发性疼痛障碍的青少年中尚未得到研究。
研究焦虑和抑郁症状是否介导慢性疼痛青少年的睡眠质量与疼痛结果之间的关系。
参与者包括147名年龄在8至18岁之间的青少年（66.7%为女性），他们被转诊至三级慢性疼痛项目。在入院时，这些青少年完成了关于睡眠质量、疼痛强度、疼痛干扰以及焦虑和抑郁症状的心理测量学可靠的测量。
如假设的那样，睡眠质量差与疼痛强度增加和疼痛干扰增加有关，并且焦虑和抑郁症状介导了这些睡眠与疼痛的关系。
对于患有慢性疼痛的青少年，睡眠质量差可能通过情绪和焦虑的改变而加重疼痛；然而，需要使用客观测量方法进行前瞻性研究。未来的研究应该检查在治疗中针对睡眠和内化性心理健康症状是否能改善这些青少年的疼痛结果。
