Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA 19104, USA.
Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA.
Sleep Health. 2022 Oct;8(5):467-474. doi: 10.1016/j.sleh.2022.05.009. Epub 2022 Jul 21.
Chronic pain and insomnia symptoms are prevalent in adolescents. This study examined the prospective associations between pain and insomnia symptoms in a large sample of adolescents.
A total of 7072 adolescents (mean age = 14.6 years) participated in a longitudinal study of behavior and health in Shandong, China. A baseline survey was conducted in November-December of 2015, and a follow-up survey was conducted one year later. A self-administered questionnaire was used to assess headache, stomachache, other nonspecific pain, depression, substance use, and family environment. The Youth Self-Rating Insomnia Scale was used to measure insomnia symptoms.
At baseline and 1-year follow-up, frequent pain was reported by 8.4% and 7.8% of the sample, respectively; moderate to severe insomnia symptoms were reported by 15.2% and 14.8%, respectively. Logistic regression analyses showed that frequent pain at baseline was significantly associated with increased odds of incident insomnia symptoms at 1-year follow-up (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.23-2.34) while adjusting for adolescent and family covariates. On the other hand, insomnia symptoms at baseline were significantly associated with increased odds of incident frequent pain at 1-year follow-up (OR = 2.00, 95% CI = 1.50-2.68). The 3 types of pain (ie, headache, stomachache, and other nonspecific pain) had similar associations with insomnia symptoms.
The findings suggest that the associations between frequent pain and insomnia are bidirectional, independent of multiple adolescent and family covariates. These findings stress the importance of assessment and management of both pain and insomnia symptoms in adolescents in routine clinical practice and school-based intervention programs.
慢性疼痛和失眠症状在青少年中普遍存在。本研究在一个大型青少年样本中考察了疼痛与失眠症状之间的前瞻性关联。
共有 7072 名青少年（平均年龄 14.6 岁）参加了中国山东一项关于行为和健康的纵向研究。基线调查于 2015 年 11 月至 12 月进行，一年后进行了随访调查。采用自填式问卷评估头痛、胃痛、其他非特异性疼痛、抑郁、物质使用和家庭环境。采用青少年自评失眠量表评估失眠症状。
基线时和 1 年随访时，分别有 8.4%和 7.8%的样本报告有频繁疼痛；分别有 15.2%和 14.8%的样本报告有中度至重度失眠症状。逻辑回归分析显示，基线时频繁疼痛与 1 年随访时新发失眠症状的几率增加显著相关（比值比 [OR] = 1.70，95%置信区间 [CI] = 1.23-2.34），同时调整了青少年和家庭协变量。另一方面，基线时的失眠症状与 1 年随访时新发频繁疼痛的几率增加显著相关（OR = 2.00，95% CI = 1.50-2.68）。3 种类型的疼痛（即头痛、胃痛和其他非特异性疼痛）与失眠症状具有相似的关联。
这些发现表明，频繁疼痛与失眠之间的关联是双向的，独立于多种青少年和家庭协变量。这些发现强调了在常规临床实践和基于学校的干预计划中评估和管理青少年的疼痛和失眠症状的重要性。
