Sleep patterns in children and adolescents with functional recurrent abdominal pain: objective versus subjective assessment

Haim, Amir; Pillar, Giora; Pecht, Avi; Lerner, Aaron B.; Tov, Naveh; Jaffe, Michael; Hardoff, Daniel

doi:10.1111/j.1651-2227.2004.tb02996.x

Cited by 39 publications

(19 citation statements)

References 27 publications

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“…However, research on sleep in children with chronic abdominal pain, specifically, is limited. A few studies have found that children with abdominal pain self-report higher levels of sleep disturbance than healthy controls, particularly in the areas of sleep onset/maintenance and excessive daytime sleepiness [8,9]. Consistent with this, studies have estimated the prevalence of poor sleep at 25-30% for adults with FGIDs [10-13].…”

Section: Introductionmentioning

confidence: 95%

Sleep problems and functional disability in children with functional gastrointestinal disorders: An examination of the potential mediating effects of physical and emotional symptoms

et al. 2012

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BackgroundSleep disturbances are increasingly recognized as a common problem for children and adolescents with chronic pain conditions, but little is known about the prevalence, type, and impact of sleep problems in pediatric functional gastrointestinal disorders (FGIDs). The objectives of the current study were two-fold: 1) to describe the pattern of sleep disturbances reported in a large sample of children and adolescents with FGIDs; and, 2) to explore the impact of sleep by examining the inter-relationships between sleep disturbance, physical symptoms, emotional problems, and functional disability in this population.MethodsOver a 3-year period, 283 children aged 8–17 years who were diagnosed with an FGID and a primary caretaker independently completed questionnaires regarding sleep, emotional functioning, physical symptoms, and functional disability during an initial evaluation for chronic abdominal pain at a pediatric tertiary care center. A verbal review of systems also was collected at that time. Descriptive statistics were used to characterize the pattern of sleep disturbances reported, while structural equation modeling (SEM) was employed to test theorized meditational relationships between sleep and functional disability through physical and emotional symptoms.ResultsClinically significant elevations in sleep problems were found in 45% of the sample, with difficulties related to sleep onset and maintenance being most common. No difference was seen by specific FGID or by sex, although adolescents were more likely to have sleep onset issues than younger children. Sleep problems were positively associated with functional disability and physical symptoms fully mediated this relationship. Emotional symptoms, while associated with sleep problems, evidenced no direct link to functional disability.ConclusionsSleep problems are common in pediatric FGIDs and are associated with functional disability through their impact on physical symptoms. Treatments targeting sleep are likely to be beneficial in improving physical symptoms and, ultimately, daily function in pediatric FGIDs.

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Section: Introductionmentioning

confidence: 95%

Sleep problems and functional disability in children with functional gastrointestinal disorders: An examination of the potential mediating effects of physical and emotional symptoms

et al. 2012

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“…Findings on objectively measured sleep are equivocal. While some research shows adolescents with chronic pain have lower sleep efficiency compared to healthy adolescents 20, other findings indicate similar sleep latency, efficiency, and duration 8.…”

Section: Introductionmentioning

confidence: 97%

“…Chronic pain is reported in 20–40% of youth 22, with the majority reporting sleep disturbances 9, 25 including shorter sleep duration 21, 28, poorer sleep quality 8, 20, and more night wakings 13, 36. Disturbed sleep in youth with chronic pain is associated with limitations in social functioning 9, lower quality of life, and greater disability 12, 18.…”

Section: Introductionmentioning

confidence: 99%

Temporal daily associations between pain and sleep in adolescents with chronic pain versus healthy adolescents

Lewandowski

Palermo

Motte

et al. 2010

Pain

136

118

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Adolescents with chronic pain frequently report sleep disturbances, particularly short sleep duration, night wakings, and poor sleep quality. Prior research has been limited by assessment of subjectively reported sleep only and lack of data on daily relationships between sleep and pain. The current study utilized multilevel modeling to compare daily associations between sleep and pain in adolescents with chronic pain and healthy adolescents. Ninety-seven adolescents (n=39 chronic pain; n=58 healthy) aged 12-18, 70.1% female participated. Adolescents completed pain diary ratings (0-10 NRS) and actigraphic sleep monitoring for 10 days. Actigraphic sleep variables (duration, efficiency, WASO) and self-reported sleep quality were tested as predictors of next-day pain, and daytime pain was tested as a predictor of sleep that night. Effects of age, gender, study group, and depressive symptoms on daily associations between sleep and pain were also tested. Multivariate analyses revealed that nighttime sleep (p<.001) and minutes awake after sleep onset (WASO) (p<.05) predicted next-day pain, with longer sleep duration and higher WASO associated with higher pain. Contrary to hypotheses, neither nighttime sleep quality nor sleep efficiency predicted pain the following day. The interaction between nighttime sleep efficiency and study group was significant, with adolescents with pain showing stronger associations between sleep efficiency and next day pain than healthy participants (p=.05). Contrary to hypotheses, daytime pain did not predict nighttime sleep. Daily associations between pain and sleep suggest that further work is needed to identify specific adolescent sleep behaviors (e.g., compensatory sleep behaviors) that may be targeted in interventions.

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“…8 Recent findings have demonstrated that these children and adolescents experience difficulty falling asleep, frequent night awakenings, early morning awakening, and excessive daytime sleepiness. For example, research with subjective and objective sleep measures has documented more nightly arousals and awakenings per hour, higher levels of sleep anxiety, and more daytime sleepiness in children with JRA compared to healthy children, 1,22 and that pain was positively correlated with their reports of sleep disturbances.…”

mentioning

confidence: 99%

“…For example, in a recent study that compared objective to subjective assessment of sleep patterns in children and adolescents with recurrent abdominal pain, the authors found that objective sleep patterns were similar to a healthy control group, whereas subjective reports of sleep were different. 8 Moreover, our study was limited by use of adolescent self-report for all outcome measures, and because of shared method variance, it might have increased the likelihood of finding significant relationships among pain, sleep disturbances, and functional limitations. Third, the correlational design also prohibits conclusions concerning the direction of effects.…”

mentioning

confidence: 99%

Subjective sleep disturbances in adolescents with chronic pain: Relationship to daily functioning and quality of life

Palermo

Kiska

2005

The Journal of Pain

143

129

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Sleep patterns in children and adolescents with functional recurrent abdominal pain: objective versus subjective assessment

Abstract: This study of a small group of children and adolescents with functional RAP provides objective evidence that their sleep patterns do not differ from those of normal peers, despite their subjective complaints.

Cited by 39 publications

References 27 publications

Sleep problems and functional disability in children with functional gastrointestinal disorders: An examination of the potential mediating effects of physical and emotional symptoms

Sleep problems and functional disability in children with functional gastrointestinal disorders: An examination of the potential mediating effects of physical and emotional symptoms

Temporal daily associations between pain and sleep in adolescents with chronic pain versus healthy adolescents

Subjective sleep disturbances in adolescents with chronic pain: Relationship to daily functioning and quality of life

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