Pediatric sickle cell pain-sleep relationships: The roles of positive and negative affect.

Abstract

Objective: The current study investigated the role of affect in the daily sleep quality-pain severity relationship in youth with sickle cell disease (SCD). Previous investigations have not allowed researchers to examine whether positive and negative affect work differentially in their relations with pediatric SCD pain, sleep, and the sleep-pain relationship. The current study focused on examining the possible mediating and moderating roles positive and negative affect have in the sleep-pain relationship for youth with SCD. Method: Eighty-eight youth with SCD (aged 8-17 years), and their guardians were recruited from three regional pediatric SCD clinics. Youth completed a twice daily ecological momentary assessment, where they reported on their daily pain severity, sleep quality, positive affect and negative affect. Multilevel models were calculated to examine the relationship between negative affect, positive affect, and the sleep-pain relationship. Results: Multilevel mediation analyses indicated that low positive affect mediated the daily cyclic relationships between poor sleep and high pain. Moderation analyses indicated that high negative affect strengthened the relationship between high pain severity and poor sleep quality that night. Conclusion: Further research is needed to examine the differential roles of positive and negative affect in other pain and adult SCD populations. Research examining the mechanisms by which positive and negative affect may influence the sleep-pain relationship is needed to inform future interventions to improve sleep and pain in the pediatric SCD population.

The relationship between pain and sleep in pediatric sickle cell disease

“…It is important for future studies to include measuring sleep outcomes for patients during acute pain requiring ED or inpatient care. We did not include measures of mood or affect in mediating the association between sleep and pain, which has been mentioned in the literature 40,41 . As PROMIS and μMCTQ item banks are subjective measures of sleep quality and duration, objective measures such as polysomnography and actigraphy could have been used to more accurately measure the sleep variables.…”

“…We did not include measures of mood or affect in mediating the association between sleep and pain, which has been mentioned in the literature. 40,41 As PROMIS and μMCTQ item banks are subjective measures of sleep quality and duration, objective measures such as polysomnography and actigraphy could have been used to more accurately measure the sleep variables. However, it has been reported in the literature that subjective outcomes of sleep measured through surveys were significantly correlated with diary and actigraphy values in adolescents.…”

Combining Ozonated Autohemotherapy with Pharmacological Therapy for Comorbid Insomnia and Myofascial Pain Syndrome: A Prospective Randomized Controlled Study

“…Pain can directly affect patients' sleep quality, and insomnia will reduce patients' pain perception threshold and increase their pain sensitivity. In addition, negative emotions, including depression, anxiety, and boredom, are important mediators connecting the relationship between pain and insomnia [ 23 ]. Pain, insomnia, and negative emotions form a triangular relationship wherein these three aggravate each other.…”

Comment on: Intraindividual pain variability metrics for youth with sickle cell disease: Relations to health outcomes

“…High negative affect enhanced the connection between high pain intensity and poor sleep quality that night. 7 Research from 2022 investigated sleep disruptions and neurocognitive performance in pediatric SCD. 8 This study's results could broaden expanded the discussion given the interrelatedness of pain, sleep, and neurocognitive performance.…”