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Changes in Sleep Habits in Adolescents During Intensive Interdisciplinary Pediatric Pain Rehabilitation

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Abstract

Sleep behaviors play an important role in the experience of chronic pain in adolescence; less well known is the effect of improved sleep in the context of pain rehabilitation. This study examined changes in sleep habits and their association with pain and functioning following day-hospital interdisciplinary pediatric pain rehabilitation. Participants (84 % female) were a cohort of 274 youth (ages 10–18, mean age 14.6 years) with neuropathic or musculoskeletal pain and associated disability who completed measures at admission, discharge, and short term (1–3 month) follow-up. Parents reported on the child’s sleep habits; participants reported on pain, functional disability, and school functioning. Results show that sleep habits improved over the course of intensive pain rehabilitation treatment, with continued improvements at follow-up. Sleep habits at discharge correlated with concurrent measures of functional disability and mood symptoms, with healthier sleep habits being associated with less disability and fewer mood symptoms. Furthermore, greater sleep duration, less sleep onset delay, and fewer night wakings correlated with lower pain intensity ratings at discharge. Controlling for change in pain with treatment, baseline sleep habits, age, and concurrent depressive symptoms, sleep habits at discharge predicted global functioning and school functioning measured at follow-up. There was modest support for changes in sleep habits over the course of treatment predicting pain reduction at follow-up, with decreased night wakings significantly predicting reduced pain intensity at follow-up. Improvements in sleep habits may be one mechanism of efficacy for intensive pediatric pain rehabilitation.

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Acknowledgments

This study was supported by the Sara Page Mayo Endowment for Pediatric Pain Research (to Charles Berde, MD, PhD), a Deborah Monroe Noonan Foundation grant (DL), and by the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children’s Hospital. We thank Charles B. Berde MD, PhD for support of this work, Anne Pauler for help with data collection and management, and Ana El-Benhadli for assistance with manuscript preparation. Thanks also to the staff, patients and families of the Pediatric Pain Rehabilitation Center of Boston Children’s Hospital at Waltham.

Conflict of interest

None.

Author contributions

D.L. conceived of the study, participated in its design and coordination, conducted statistical analyses, drafted and edited the manuscript; C.S. participated in conceptualizing the study, participated in design, analysis and interpretation of the data, and wrote substantive portions of the manuscript; C.C. participated in conceptualizing the study, participated in design and interpretation of the data, and assisted with writing and editing the manuscript; K.S. assisted with data management, statistical analyses, drafting portions of the paper and formatting the manuscript; S.O. participated in conceptualizing the study and its design and coordination, and provided valuable input on the manuscript; N.S. participated in conceptualizing the paper, advised on medical aspects of the study and provided valuable input on the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Pain Treatment Service, 333 Longwood Ave, Boston, MA, 02115, USA

    Deirdre E. Logan, Christine B. Sieberg, Caitlin Conroy, Kelly Smith, Shannon Odell & Navil Sethna

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  1. Deirdre E. Logan
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  2. Christine B. Sieberg
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  3. Caitlin Conroy
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  5. Shannon Odell
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Correspondence to Deirdre E. Logan.

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Logan, D.E., Sieberg, C.B., Conroy, C. et al. Changes in Sleep Habits in Adolescents During Intensive Interdisciplinary Pediatric Pain Rehabilitation. J Youth Adolescence 44, 543–555 (2015). https://doi.org/10.1007/s10964-014-0155-2

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  • DOI: https://doi.org/10.1007/s10964-014-0155-2

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