TY - JOUR
T1 - Behavioral and psychosocial factors associated with insomnia in adolescents with chronic pain
AU - Palermo, Tonya M.
AU - Wilson, Anna C.
AU - Lewandowski, Amy S.
AU - Toliver-Sokol, Marisol
AU - Murray, Caitlin B.
N1 - Funding Information:
This study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development R01HD053431 awarded to the first author (T.M.P.). We wish to thank the teens and families who participated in this study. We also acknowledge Cameron Brick, Ashley Moss, and Hanna Nelson who provided invaluable research assistance.
PY - 2011/1
Y1 - 2011/1
N2 - This study aimed to (1) identify differences in sleep behaviors, sleep quality, pre-sleep arousal and prevalence of insomnia symptoms in adolescents with chronic pain compared to a healthy age and sex-matched cohort and (2) examine pain intensity, pubertal development, depression, and pre-sleep arousal as risk factors for insomnia symptoms. Participants included 115 adolescents, 12-18 years of age (73.0% female), 59 youth with chronic pain and 56 healthy youth. During a home-based assessment, adolescents completed validated measures of pain, sleep quality, sleep hygiene, pre-sleep arousal, depressive symptoms, and pubertal development. Findings revealed a significantly higher percentage of adolescents with chronic pain reporting symptoms of insomnia (54.2%) compared to healthy adolescents (19.6%), p < .001. Youth with chronic pain also reported higher cognitive and somatic arousal at bedtime, and lower sleep quality compared to the healthy cohort. In a logistic regression, two factors emerged as significant predictors of insomnia, having chronic pain (OR = 6.09) and higher levels of cognitive pre-sleep arousal (OR = 1.24). Level of pain intensity did not predict insomnia. While sleep disruption may initially relate to pain, these symptoms may persist into a separate primary sleep disorder over time due to other behavioral and psychosocial factors. Assessment of insomnia may be important for identifying behavioral targets for the delivery of sleep-specific interventions to youth with chronic pain.
AB - This study aimed to (1) identify differences in sleep behaviors, sleep quality, pre-sleep arousal and prevalence of insomnia symptoms in adolescents with chronic pain compared to a healthy age and sex-matched cohort and (2) examine pain intensity, pubertal development, depression, and pre-sleep arousal as risk factors for insomnia symptoms. Participants included 115 adolescents, 12-18 years of age (73.0% female), 59 youth with chronic pain and 56 healthy youth. During a home-based assessment, adolescents completed validated measures of pain, sleep quality, sleep hygiene, pre-sleep arousal, depressive symptoms, and pubertal development. Findings revealed a significantly higher percentage of adolescents with chronic pain reporting symptoms of insomnia (54.2%) compared to healthy adolescents (19.6%), p < .001. Youth with chronic pain also reported higher cognitive and somatic arousal at bedtime, and lower sleep quality compared to the healthy cohort. In a logistic regression, two factors emerged as significant predictors of insomnia, having chronic pain (OR = 6.09) and higher levels of cognitive pre-sleep arousal (OR = 1.24). Level of pain intensity did not predict insomnia. While sleep disruption may initially relate to pain, these symptoms may persist into a separate primary sleep disorder over time due to other behavioral and psychosocial factors. Assessment of insomnia may be important for identifying behavioral targets for the delivery of sleep-specific interventions to youth with chronic pain.
KW - Adolescent
KW - Chronic pain
KW - Depression
KW - Insomnia
KW - Sleep
UR - http://www.scopus.com/inward/record.url?scp=78650414064&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78650414064&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2010.09.035
DO - 10.1016/j.pain.2010.09.035
M3 - Article
C2 - 21030151
AN - SCOPUS:78650414064
SN - 0304-3959
VL - 152
SP - 89
EP - 94
JO - Pain
JF - Pain
IS - 1
ER -