Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms

Background. Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populatio...

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Main Authors: Maria Pavlova, Jennifer Ference, Megan Hancock, Melanie Noel
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2017/1586921
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author Maria Pavlova
Jennifer Ference
Megan Hancock
Melanie Noel
author_facet Maria Pavlova
Jennifer Ference
Megan Hancock
Melanie Noel
author_sort Maria Pavlova
collection DOAJ
description Background. Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populations with pain-related chronic illnesses suggest that internalizing mental health symptoms may mediate the sleep-pain relationship; however, this has not been examined in youth with primary pain disorders. Objective. To examine whether anxiety and depressive symptoms mediated relationships between sleep quality and pain outcomes among youth with chronic pain. Methods. Participants included 147 youth (66.7% female) aged 8–18 years who were referred to a tertiary-level chronic pain program. At intake, the youth completed psychometrically sound measures of sleep quality, pain intensity, pain interference, and anxiety and depressive symptoms. Results. As hypothesized, poor sleep quality was associated with increased pain intensity and pain interference, and anxiety and depressive symptoms mediated these sleep-pain relationships. Discussion. For youth with chronic pain, poor sleep quality may worsen pain through alterations in mood and anxiety; however, prospective research using objective measures is needed. Future research should examine whether targeting sleep and internalizing mental health symptoms in treatments improve pain outcomes in these youth.
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spelling doaj-art-5197d1a3745c4a7ab4fac7b6f3a1ff522025-08-20T02:05:16ZengWileyPain Research and Management1203-67651918-15232017-01-01201710.1155/2017/15869211586921Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health SymptomsMaria Pavlova0Jennifer Ference1Megan Hancock2Melanie Noel3Department of Psychology, University of Calgary, Calgary, AB, CanadaDepartment of Psychology, University of Calgary, Calgary, AB, CanadaAlberta Children’s Hospital, Calgary, AB, CanadaDepartment of Psychology, University of Calgary, Alberta Children’s Hospital Research Institute (Behaviour and the Developing Brain Theme), Mathison Centre for Mental Health Research and Education, Calgary, AB, CanadaBackground. Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populations with pain-related chronic illnesses suggest that internalizing mental health symptoms may mediate the sleep-pain relationship; however, this has not been examined in youth with primary pain disorders. Objective. To examine whether anxiety and depressive symptoms mediated relationships between sleep quality and pain outcomes among youth with chronic pain. Methods. Participants included 147 youth (66.7% female) aged 8–18 years who were referred to a tertiary-level chronic pain program. At intake, the youth completed psychometrically sound measures of sleep quality, pain intensity, pain interference, and anxiety and depressive symptoms. Results. As hypothesized, poor sleep quality was associated with increased pain intensity and pain interference, and anxiety and depressive symptoms mediated these sleep-pain relationships. Discussion. For youth with chronic pain, poor sleep quality may worsen pain through alterations in mood and anxiety; however, prospective research using objective measures is needed. Future research should examine whether targeting sleep and internalizing mental health symptoms in treatments improve pain outcomes in these youth.http://dx.doi.org/10.1155/2017/1586921
spellingShingle Maria Pavlova
Jennifer Ference
Megan Hancock
Melanie Noel
Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms
Pain Research and Management
title Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms
title_full Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms
title_fullStr Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms
title_full_unstemmed Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms
title_short Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms
title_sort disentangling the sleep pain relationship in pediatric chronic pain the mediating role of internalizing mental health symptoms
url http://dx.doi.org/10.1155/2017/1586921
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