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A systematic review of sleep in pediatric pain populations
Cecelia R Valrie1, Maggie H Bromberg, Tonya Palermo
1Department of Psychology, East Carolina University, Greenville, NC 27858, USA. valriec@ecu.edu
Insights
Children and adolescents with persistent pain often experience sleep problems. This review highlights the need for healthcare providers to screen for and treat sleep issues in this population.
Area of Science:
- Pediatric Health
- Sleep Medicine
- Pain Management
Background:
- Persistent pain in children and adolescents is a significant health concern.
- The relationship between pain and sleep in pediatric populations requires further investigation.
Purpose of the Study:
- To systematically review existing evidence on the pain-sleep relationship in children with persistent pain.
- To examine studies utilizing single and mixed pediatric persistent pain samples.
Main Methods:
- Conducted comprehensive electronic searches of major databases (Medline, PubMed, Cochrane, PsycINFO).
- Included empirical studies with participants aged 0-17 years across various pediatric pain conditions (e.g., juvenile idiopathic arthritis, sickle cell disease, migraine, functional abdominal pain, fibromyalgia, chronic musculoskeletal pain).
Main Results:
- Evidence from single and mixed sample studies supports a link between persistent pain and sleep impairment in children and adolescents.
- A model illustrating the interrelationships between pain, sleep, mediating factors, and functional outcomes was developed.
Conclusions:
- Sleep problems are prevalent in children with persistent pain and require assessment and treatment.
- Healthcare providers should implement routine sleep screenings for pediatric pain patients.
- Future research should focus on the mechanisms linking sleep and pediatric persistent pain and the impact on functional outcomes.
Objective:
The primary aim of this systematic review was to examine the evidence for a pain-sleep relationship in children with persistent pain by reviewing studies using single and mixed pediatric persistent pain samples.
Methods:
Electronic searches of Medline, PubMed, the Cochrane Database of Systematic Reviews, and PsycINFO were conducted to identify all relevant empirical studies. Studies were included in the review if the majority of participants were between 0 and 17 years and from one of the following pediatric pain populations: juvenile idiopathic arthritis, sickle cell disease, migraine/headache, functional abdominal pain, juvenile fibromyalgia syndrome, chronic musculoskeletal pain, or mixed populations including the aforementioned conditions.
Results:
Research from single and mixed sample studies support the hypothesis that children and adolescents with persistent pain suffer from sleep impairment. Literature addressing factors that may influence or mediate the pain-sleep relationship and the functional outcomes of the pain-sleep relationship was reviewed, and a model of the interrelationships with pain and sleep was developed.
Conclusion:
Findings from this review highlight the need to assess and treat sleep problems in children presenting with persistent pain. Health care providers should consider conducting routine sleep screenings, including a comprehensive description of sleep patterns and behaviors obtained through clinical interview, sleep diaries, and/or the use of standardized measures of sleep. Future research focusing on investigating the mechanisms associating sleep and pediatric persistent pain and on functional outcomes of poor sleep in pediatric pain populations is needed.
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