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一夜好眠:脑瘫患儿的疼痛轨迹与睡眠障碍

A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy.

作者信息

Shearer Heather M, Côté Pierre, Hogg-Johnson Sheilah, Fehlings Darcy L

机构信息

Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.

Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.

出版信息

J Clin Sleep Med. 2024 May 1;20(5):719-726. doi: 10.5664/jcsm.10980.

Abstract

STUDY OBJECTIVES

Sleep quality is important during childhood and adolescence. Given the high prevalence of pain in children/youth with cerebral palsy, we aimed to measure the association between short-term pain trajectories and sleep disturbance in these individuals.

METHODS

We accrued the cohort between November 2019 and October 2020 and recruited children/youth who (1) were 8-18 years old; (2) had cerebral palsy with any Gross Motor Function Classification System level; and (3) could self-report pain and sleep disturbance. We collected self-reported baseline and weekly follow-up data using electronic questionnaires completed every week for 5 weeks. Sleep disturbance at 5 weeks was the primary outcome (pediatric Patient-Reported Outcomes Measurement Information System short form, v1.0-4a). We used general linear regression to assess the association between pain intensity trajectory group and sleep disturbance controlling for confounders.

RESULTS

A total of 190 individuals were eligible; 102 were enrolled and 89 were included in our final analysis. Pain trajectory groups had estimated crude mean sleep disturbance scores at 5 weeks ranging from 56.0 (95% confidence interval, 51.8, 60.8) to 61.8 (55.7, 67.9). Compared to those with stable, no/very mild pain, those in the stable, high-pain group had the greatest sleep disturbance (adjusted β = 5.7; 95% confidence interval, 1.2, 10.2).

CONCLUSIONS

Irrespective of pain trajectory, children and youth with cerebral palsy reported sleep disturbances. Those with a stable, high pain intensity in the previous 5 weeks reported the greatest sleep disturbance. The results highlight the importance of considering pain trajectories and their impact on sleep in children with cerebral palsy.

CITATION

Shearer HM, Côté P, Hogg-Johnson S, Fehlings DL. A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy. . 2024;20(5):719-726.

摘要

研究目的

睡眠质量在儿童期和青少年期至关重要。鉴于脑瘫儿童/青少年中疼痛的高患病率,我们旨在测量这些个体短期疼痛轨迹与睡眠障碍之间的关联。

方法

我们在2019年11月至2020年10月期间招募了该队列,纳入了符合以下条件的儿童/青少年:(1)年龄在8 - 18岁;(2)患有任何粗大运动功能分类系统水平的脑瘫;(3)能够自我报告疼痛和睡眠障碍。我们使用电子问卷收集自我报告的基线数据和每周随访数据,每周填写一次,共5周。5周时的睡眠障碍是主要结局(儿科患者报告结局测量信息系统简表,v1.0 - 4a)。我们使用一般线性回归来评估疼痛强度轨迹组与控制混杂因素后的睡眠障碍之间的关联。

结果

共有190人符合条件;102人被纳入研究,89人纳入我们的最终分析。疼痛轨迹组在5周时估计的粗平均睡眠障碍得分范围为56.0(95%置信区间,51.8,60.8)至61.8(55.7,67.9)。与疼痛稳定、无/非常轻微的患者相比,稳定的高疼痛组的睡眠障碍最大(调整后β = 5.7;95%置信区间,1.2,10.2)。

结论

无论疼痛轨迹如何,脑瘫儿童和青少年均报告存在睡眠障碍。在过去5周内疼痛强度稳定且高的患者报告的睡眠障碍最大。结果强调了考虑疼痛轨迹及其对脑瘫儿童睡眠影响的重要性。

引用文献

希勒HM,科特P,霍格 - 约翰逊S,费林斯DL。睡个好觉:脑瘫儿童的疼痛轨迹与睡眠障碍。. 2024;20(5):719 - 726。

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本文引用的文献

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