Sleep Characteristics of Youth with Functional Abdominal Pain and a Healthy Comparison Group

Huntley, Edward D.; Campo, John V.; Dahl, Ronald E.; Lewin, Daniel

doi:10.1093/jpepsy/jsm032

Cited by 61 publications

(46 citation statements)

References 51 publications

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“…18 Also, FAP is reportedly associated with increased difficulty initiating and maintaining sleep, symptoms that were defined as behavioral sleep-disorder symptoms, which are common in children with medical and psychiatric disorders. 19 To our knowledge, we are the first to find a negative association between epigastric pain and CAP. A possible explanation is that epigastric pain is caused by, for example, gastritis or gastroenteritis, conditions that are mostly self-limiting.…”

Section: Discussionmentioning

confidence: 84%

“…Historically, this factor has been considered a red flag symptom, but more recent data suggest an association with FAP. 18,19 In addition to assessing positive predictors after 1 year, we also investigated several red flag symptoms: vomiting, fever, blood on stools, and dysuria. We hypothesized that these symptoms are related to organic diseases that are mostly self-limiting or worsen in the long term, thus being recognized and treated as such.…”

Section: Potential Predictorsmentioning

confidence: 99%

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Predictors of Chronic Abdominal Pain Affecting the Well-Being of Children in Primary Care

Spee

Leeuwen

Benninga

et al. 2015

The Annals of Family Medicine

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PURPOSE Abdominal pain is a frequent symptom among children but is rarely associated with organic disease. Although it may persist for years, no factors have been identified that predict its prognosis. Our aim was to determine whether patient characteristics at initial consultation can predict chronic abdominal pain severe enough to influence the child's well-being at 1 year of follow-up. METHODSWe conducted this prospective cohort study in primary care, including consecutive children aged 4 to 17 years seen for abdominal pain by their family physician. Multivariate logistic regression analysis was used to identify prognostic factors that predicted chronic abdominal pain 1 year later. Discriminative ability of identified predictors was assessed using the area under the receiver operating characteristic curve and explained variance. RESULTSThe risk of having chronic abdominal pain at 1 year of follow-up was 37.1% in the cohort overall. Increasing age, waking up at night with pain, high levels of other somatic complaints, and chronic abdominal pain at baseline independently predicted chronic abdominal pain at 1 year. These predictors had a poor to moderate discriminative ability, however; the area under the receiver operating characteristic curve was only 0.69, and the predictors collectively explained only 14.3% of variance in the development of chronic abdominal pain. The absolute risk ranged from 19.4% among children having none of the predictors to 65.5% among children having 3 or 4 predictors.CONCLUSIONS Chronic abdominal pain sufficient to affect well-being is common among children initially seen for abdominal pain by family physicians. Although the risk of this outcome increases with number of predictors, these predictors are of limited value in identifying children in whom pain will become chronic, suggesting that other, as yet unidentified factors play an important role. Ann Fam Med 2015;13:158-163. doi: 10.1370/afm.1736. INTRODUCTIONA bdominal pain in children accounts for about 5% of childhood consultations in general practice in the Netherlands, 1 which is in agreement with studies performed in Australia and the United States reporting similar numbers of 2% to 4%.2,3 Most cases are considered medically unexplained and are labeled as functional abdominal pain (FAP). 4 In 10% to 15% of schoolchildren, abdominal pain persists or returns regularly, which increases health care use and has implications for the child's well-being in that they have poorer school attendance, withdraw from social activities, and show impaired physical abilities. [5][6][7] One in 3 children with chronic FAP continues to experience this pain for at least 5 years, underscoring the burden of disease. 8 In addition, childhood FAP has been linked to functional gastrointestinal (GI) disorders in adulthood, such as irritable bowel syndrome. [9][10][11][12][13] Despite evidence that childhood FAP may persist for years, few factors have been identified that predict whether it interferes with the child's wellbeing. 13 Recently, a h...

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Section: Discussionmentioning

confidence: 84%

Section: Potential Predictorsmentioning

confidence: 99%

Predictors of Chronic Abdominal Pain Affecting the Well-Being of Children in Primary Care

Spee

Leeuwen

Benninga

et al. 2015

The Annals of Family Medicine

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“…Data indicate that acute and chronic medical conditions appear to increase youth risk of sleep disruptions (Huntley, Campo, Dahl, & Lewin, 2007; Hysing, Sivertsen, Stormark, Elgen, & Lundervold, 2009; Passarelli et al, 2006) and there is some evidence that sleep problems are more often chronic and persistent in youth with chronic conditions compared to those without chronic conditions (Sivertsen, Hysing, Elgen, Stormark, & Lundervold, 2009). Over the past decade, research has increasingly recognized the importance of sleep and the adverse daytime consequences and health outcomes of untreated sleep disturbances and sleep disorders.…”

mentioning

confidence: 99%

Examination of the Factor Structure of the Adolescent Sleep–Wake Scale (ASWS)

Essner¹,

Noel²,

Myrvik

et al. 2014

Behavioral Sleep Medicine

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This study examined the factor structure of the Adolescent Sleep–Wake Scale (ASWS) among 491 adolescents (12–18 years) with and without pediatric health conditions. Exploratory factor analyses were conducted using iterated principal axis factoring with varimax rotation. Highly cross-loading items were systematically removed and analyses were rerun until a clean solution was attained. The final solution explained 57.1% of the total model variance, including 10 items and three factors: Falling Asleep and Reinitiating Sleep-Revised, returning to Wakefulness-Revised, and Going to Bed-Revised. Internal consistency reliability scores were acceptable to good, with the exception of the Going to Bed-Revised subscale for the healthy sample. Adolescents with chronic pain reported significantly poorer overall sleep quality and more problems in falling asleep, reinitiating sleep, and returning to wakefulness as compared to healthy adolescents, providing preliminary evidence for construct validity of the new factors. The resulting ASWS version is a concise assessment tool with empirically derived, distinct behavioral sleep dimensions that can be used for clinical and research purposes.

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“…A explicação para isso se daria em razão a uma interpretação aumentada de estressores psicológicos em diversos aspectos de suas vidas quando comparados a indivíduos sem dor crô-nica. A associação entre humor deprimido, estresse, dor e sono é suscetível de ser particularmente forte em indivíduos jovens, que ainda estão desenvolvendo suas habilidades para regular a emoção, a atenção e as respostas comportamentais ao estresse (13) . Dessa forma, tais estudos sugerem que múltiplos estressores podem aumentar o risco de problemas comportamentais e de saúde.…”

Section: Discussionunclassified

Dor musculoesquelética idiopática difusa na infância e na adolescência

Molina

Silva

Teles

et al. 2011

Rev. paul. pediatr.

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ResumoObjetivo: A dor musculoesquelética difusa idiopática persistente ou intermitente é definida pela presença de dor com duração de três meses ou mais, sem etiologia aparente, e tem acometido cada vez mais crianças e adolescentes. Este estudo objetivou relatar dois pacientes com dor incapacitante submetidos à abordagem e ao tratamento multiprofissional, além de discutir o tratamento conduzido, por meio de revisão da literatura atual.Descrição do caso: O primeiro caso é de uma menina com nove anos de idade, com histórico de cefaleia, dor musculoesquelética e dor abdominal há dois anos, período no qual apresentou quatro episódios de ausência de marcha, sem causas orgânicas aparentes. O segundo caso refere-se a uma adolescente de 14 anos com lombalgia diária há 14 meses de forte intensidade, com irradiação para membros inferiores, acompanhada de cefaleia, fadiga e adinamia. Ambas apresentavam exame físico normal, exceto pela presença de alodínia (caso 1) e pontos de fibromialgia (caso 2); além de exames subsidiários normais, sem justificativas orgânicas para as queixas dolorosas. Houve melhora clínica significativa após diagnóstico e tratamento diferencial por meio de abordagem multiprofissional (médico, psicólogo, fisioterapeuta e nutricionista), com retomada das atividades regulares pelas pacientes.Comentários: A atuação integrada da equipe em um curto período de tempo proporcionou às pacientes a retomada de suas atividades normais, visto que fatores emocionais, físicos e nutricionais relacionam-se à dor.Palavras-chave: dor; fibromialgia; criança; adolescente. AbstRActObjective: Persistent or intermittent diffuse idiopathic musculoskeletal pain is defined by the presence of pain over three months with no apparent etiology. The diagnosis of this condition in children and adolescents is increasing. The objective of this study was to report the cases of two patients with disabling pain that received multidisciplinary treatment and to review the current literature about this subject.Case description: The first patient is a nine-year old girl with history of headache, musculoskeletal pain and abdominal pain for two years. During this period she had four episodes of absence of gait with no apparent organic cause. The second patient is a 14-year girl with severe daily low back pain for 14 months, followed by headache and fatigue. Both patients presented a normal physical examination, except for allodynia (case 1) and fibromyalgia tender points (case 2). All tests resulted negative regarding the search for organic reasons for pain complaints. Significant clinical improvement was observed with a multidisciplinary approach offered by pediatricians, psychologists, physical therapists, and nutritionists. Both patients resumed their daily regular activities.Comments: Team integrated performance in a short-term period can provide the attenuation of pain symptoms since emotional, physical and nutritional factors are related to the pain expressed by the patients.

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Sleep Characteristics of Youth with Functional Abdominal Pain and a Healthy Comparison Group

Abstract: Sleep problems in youth with FAP warrant clinical attention and future research should continue to explore sleep problems that co-occur with and independent of psychopathology.

Cited by 61 publications

References 51 publications

Predictors of Chronic Abdominal Pain Affecting the Well-Being of Children in Primary Care

Predictors of Chronic Abdominal Pain Affecting the Well-Being of Children in Primary Care

Examination of the Factor Structure of the Adolescent Sleep–Wake Scale (ASWS)

Dor musculoesquelética idiopática difusa na infância e na adolescência

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