(113) Sleep Deficiency and Disability in Adolescents with Chronic Abdominal Pain

Abstract

Children with chronic pain commonly report comorbid sleep deficiency. However, research has been limited in pediatric chronic abdominal pain (CAP) populations. This study sought to characterize the etiology of sleep deficiency in adolescents with CAP and examine the associations between sleep and functioning. The sample included 21 adolescents 14 to 18 years old with CAP (female=85.7%, mean age=16.5 years). CAP is defined by abdominal pain present for two or more months, experienced at least four times per month, and not explained by another condition. Self-reported sleep measures provided information on insomnia symptoms and disability. Adolescents also wore an actigraph for 7 days. The average pain intensity was 5.33 (SD=2.0), and reported disability of 37.8 (SD=17.0), comparable to adolescents with other pain conditions e.g. chronic headaches. Moderately severe insomnia symptoms were reported by 33.4% of adolescents, with night time sleep duration of 7 hours 17 minutes (SD=52 min), with efficiency of 87.3% (SD=5.4%) and wake time after sleep onset of 67 minutes (SD=39 min). We found that greater insomnia symptoms (r=.571, p=0.007), poorer sleep quality (r=-.593, p=0.005) and shorter sleep duration (r=-.464, p=0.03) were associated with greater disability. Regression analyses revealed that more severe insomnia symptoms (t=2.455, p=0.025) and higher pain intensity (t=2.492, p=0.023) were associated with greater pain related disability (F2,18=8.946, p=0.002). Moreover, shorter sleep duration (t=-2.473, p=0.02) and higher pain intensity (t=3.20, p=0.005) were associated with greater disability (F2,18=9.012, p=0.002). Findings highlight that comorbid insomnia symptoms and shorter sleep duration were associated with greater disability in adolescents with CAP, supporting the importance of targeting sleep as core interventions in treatment.