Behavioral and psychosocial factors associated with insomnia in adolescents with chronic pain

Tonya M. Palermo, Anna Wilson, Amy Holley, Marisol Toliver-Sokol, Caitlin B. Murray

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

This study aimed to (1) identify differences in sleep behaviors, sleep quality, pre-sleep arousal and prevalence of insomnia symptoms in adolescents with chronic pain compared to a healthy age and sex-matched cohort and (2) examine pain intensity, pubertal development, depression, and pre-sleep arousal as risk factors for insomnia symptoms. Participants included 115 adolescents, 12-18 years of age (73.0% female), 59 youth with chronic pain and 56 healthy youth. During a home-based assessment, adolescents completed validated measures of pain, sleep quality, sleep hygiene, pre-sleep arousal, depressive symptoms, and pubertal development. Findings revealed a significantly higher percentage of adolescents with chronic pain reporting symptoms of insomnia (54.2%) compared to healthy adolescents (19.6%), p <.001. Youth with chronic pain also reported higher cognitive and somatic arousal at bedtime, and lower sleep quality compared to the healthy cohort. In a logistic regression, two factors emerged as significant predictors of insomnia, having chronic pain (OR = 6.09) and higher levels of cognitive pre-sleep arousal (OR = 1.24). Level of pain intensity did not predict insomnia. While sleep disruption may initially relate to pain, these symptoms may persist into a separate primary sleep disorder over time due to other behavioral and psychosocial factors. Assessment of insomnia may be important for identifying behavioral targets for the delivery of sleep-specific interventions to youth with chronic pain.

Original languageEnglish (US)
Pages (from-to)89-94
Number of pages6
JournalPain
Volume152
Issue number1
DOIs
StatePublished - Jan 2011

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Sleep Initiation and Maintenance Disorders
Chronic Pain
Sleep
Psychology
Arousal
Pain
Depression
Logistic Models

Keywords

  • Adolescent
  • Chronic pain
  • Depression
  • Insomnia
  • Sleep

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine
  • Neurology
  • Pharmacology

Cite this

Behavioral and psychosocial factors associated with insomnia in adolescents with chronic pain. / Palermo, Tonya M.; Wilson, Anna; Holley, Amy; Toliver-Sokol, Marisol; Murray, Caitlin B.

In: Pain, Vol. 152, No. 1, 01.2011, p. 89-94.

Research output: Contribution to journalArticle

Palermo, Tonya M. ; Wilson, Anna ; Holley, Amy ; Toliver-Sokol, Marisol ; Murray, Caitlin B. / Behavioral and psychosocial factors associated with insomnia in adolescents with chronic pain. In: Pain. 2011 ; Vol. 152, No. 1. pp. 89-94.
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