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Temporal relationship between daily pain and actigraphy sleep patterns in pediatric sickle cell disease

Karin Fisher1, Andrea M Laikin2, Katianne M Howard Sharp3

  • 1University of Southern Mississippi, 118 College Drive, Box 5025, Hattiesburg, MS, 39406, USA. karin_fisher@yahoo.com.

Journal of Behavioral Medicine
|March 14, 2018
PubMed

Insights

Children with sickle cell disease (SCD) experience worse sleep efficiency with increased pain. Poor sleep efficiency also predicts more pain the following day, highlighting sleep as a key intervention target.

Area of Science:

  • Pediatric Hematology
  • Sleep Medicine
  • Pain Management

Background:

  • Limited research exists on objective sleep patterns and pain in pediatric sickle cell disease (SCD).
  • In other chronic pain conditions, sleep disruption may impact pain more than pain impacts sleep.
  • Understanding this relationship in pediatric SCD is crucial for effective pain management.

Purpose of the Study:

  • To investigate the bi-directional relationship between objective sleep patterns and daily pain in children with SCD.
  • To determine if pain severity influences sleep quality and if sleep quality influences subsequent pain.
  • To identify sleep as a potential therapeutic target for managing pain in pediatric SCD.

Main Methods:

  • A 14-day study involving 30 children with SCD (aged 8-18) experiencing frequent pain.
  • Objective sleep data collected via ambulatory actigraphy (measuring sleep duration, efficiency, and wake after sleep onset [WASO]).
  • Subjective pain, medication, and psychosocial data gathered through daily pain diaries and questionnaires.

Main Results:

  • Greater pain severity was significantly associated with worse sleep efficiency and increased WASO on the same night.
  • Worse sleep efficiency predicted the occurrence and increased severity of pain on the following day.
  • Sleep duration and WASO did not show a significant relationship with subsequent pain levels.

Conclusions:

  • Evidence supports a bi-directional relationship between sleep parameters and daily pain in pediatric SCD.
  • Sleep efficiency, specifically, appears to be a critical factor influencing pain experiences.
  • Targeting sleep quality may offer a novel approach for pain management interventions in children with SCD.

Keywords:
ActigraphyAdolescentsChildrenPersistent painSickle cell diseaseSleep

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