Divisions of Behavioral Medicine and Clinical Psychology.
Department of Oral Health Science, University of Kentucky College of Dentistry, Lexington, KY.
Clin J Pain. 2021 Jun 1;37(6):443-453. doi: 10.1097/AJP.0000000000000936.
Intensive interdisciplinary pain treatment (IIPT) programs have been shown to restore function, improve coping, and reduce pain in adolescents with chronic pain. Yet, little is known about patients' sleep during IIPT and whether or not improvements in pain treatment outcomes are associated with changes in sleep pre-to-post IIPT treatment. The objectives of the current study were to describe sleep among adolescents entering IIPT and examine associations between sleep parameters and IIPT treatment effects.
Self-reported sleep measures and clinical outcomes (eg, functional disability, coping, average pain), were collected from 44 adolescents (mean age=14.57, 68.2% female) at admission and discharge from an inpatient IIPT program. Wrist-worn actigraphy data and sleep diaries from participants' first week and last week in the program were analyzed to characterize sleep parameters.
Participants self-reported poor sleep/wake patterns, high levels of insomnia symptoms, and subclinical problems with daytime sleepiness upon admission into IIPT, although actigraphic indices of sleep from the first week of IIPT admission were only just under clinical guidelines for healthy adolescent sleep. Better self-reported sleep quality assessed via aggregated sleep diaries from the first week was associated with improvement in average pain and disability over the course of the program. Furthermore, improvements in insomnia symptoms and daytime sleepiness throughout the program were positively correlated with concurrent improvements in functional disability and coping.
Taken together, results suggest that sleep may be associated with IIPT treatment effects and pave the way for future research to continue examining these relationships.
强化跨学科疼痛治疗（IIPT）方案已被证明可以恢复功能、改善应对能力，并减轻慢性疼痛青少年的疼痛。然而，对于 IIPT 期间患者的睡眠情况，以及疼痛治疗效果的改善是否与 IIPT 治疗前后睡眠的变化有关，我们知之甚少。本研究的目的是描述接受 IIPT 的青少年的睡眠情况，并探讨睡眠参数与 IIPT 治疗效果之间的关系。
从 44 名青少年（平均年龄为 14.57 岁，68.2%为女性）入院和出院时，收集了自我报告的睡眠测量和临床结果（例如，功能障碍、应对能力、平均疼痛）。从参与者在 IIPT 计划中的第一周和最后一周收集手腕佩戴活动记录仪数据和睡眠日记，以分析睡眠参数。
参与者在进入 IIPT 时自我报告睡眠/觉醒模式差、失眠症状严重、亚临床日间嗜睡问题，但 IIPT 入院第一周的活动记录仪睡眠指数仅略低于健康青少年睡眠的临床指南。通过第一周的综合睡眠日记评估的自我报告睡眠质量的改善与治疗过程中平均疼痛和残疾的改善相关。此外，整个方案中失眠症状和日间嗜睡的改善与功能障碍和应对能力的同时改善呈正相关。
总的来说，结果表明睡眠可能与 IIPT 治疗效果有关，并为未来研究继续研究这些关系铺平了道路。
