Functional Abdominal Pain Disorders Research Articles

Impact of Coronavirus disease 2019 pandemic in children with functional abdominal pain disorders: Data from long-term follow-up.

We aimed to compare symptom frequency and severity in children with functional abdominal pain disorders (FAPDs) and to evaluate anxiety, quality of life (QoL) and global health during Coronavirus disease 2019 (COVID-19) related quarantine and after 17 months. Children diagnosed with FAPDs between October 2019 and February 2020 at 5 different centers were enrolled and prospectively interviewed during the COVID-19 quarantine and 17 months later when schools, hospital services, and routine activities had re-opened to the public. The patients were asked to complete the Rome IV questionnaire, the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) Generic Core Scale, the Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and global health questionnaires. Data about COVID-19 infection and its clinical outcome were also collected. Ninety-nine out of 180 (55%) children completed the follow-up. The number of patients reporting a worsening of their symptoms was significantly higher at follow-up when compared to the quarantine period (24/99 [24.2%] vs. 12/99 [12.1%]; p = 0.04). The PedsQL 4.0 subtotal score at follow-up significantly decreased at 17 months of follow-up (65.57 [0-100]) when compared to the quarantine (71 [0-100], p = 0.03). Emotional functioning was the most significantly reduced (Follow-up: 64.7 [0-100] vs. Quarantine: 75 [0-100]; p = 0.006). We did not identify significant differences in symptoms and QoL between COVID-19 infected children and the remaining cohort at the two time points. An improvement of symptoms and QoL was observed during the quarantine, followed by a worsening at-follow-up. These findings reinforce the hypothesis that the nest effect overweighted COVID-19 fears during the quarantine and highlight the importance of psychological factors in symptom exacerbation.

Serum Eosinophilic Cationic Protein as a Useful Noninvasive Marker of Eosinophilic Gastrointestinal Disease in Children.

Recently, the prevalence of eosinophilic gastrointestinal disease (EGID) has shown an increasing trend worldwide. As the diagnosis of EGID requires invasive endoscopy with biopsy, noninvasive markers for detecting EGID in suspected patients, particularly children, are urgently needed. Therefore, this study aimed to evaluate the diagnostic accuracy of serum eosinophil cationic protein (ECP) beyond peripheral eosinophil counts in pediatric patients with EGID. Overall, 156 children diagnosed with EGID were enrolled and 150 children with functional abdominal pain disorder (FAPD) were recruited as controls. All participants underwent endoscopic biopsy in each segment of the gastrointestinal (GI) tract and serum ECP measurement, as well as peripheral eosinophil percent and absolute eosinophil count. Comparing EGID (n=156) with FAPD (n=150) patients, serum ECP levels were significantly higher in pediatric patients with EGID than in those with FAPD (25.8±28.6 µg/L vs. 19.5±21.0 µg/L, p=0.007), while there was no significant difference in peripheral eosinophil percent and absolute eosinophil counts between the two groups. Serum ECP levels were correlated with peripheral eosinophil percent (r=0.593, p<0.001) and the absolute eosinophil count (r=0.660, p<0.001). The optimal cutoff value of serum ECP for pediatric EGID was 10.5 µg/mL, with a sensitivity of 69.9% and a specificity of 43.4% with an area under the receiver operating characteristic curve of 0.562. The combination of serum ECP levels and peripheral eosinophil counts, when employed with appropriated thresholds, could serve as a valuable noninvasive biomarker to distinguish between EGID and FAPD in pediatric patients manifesting GI symptoms.

Opinion: Percutaneous electrical nerve field stimulation compared to standard medical therapy in adolescents with functional abdominal pain disorders.

Opinion: Percutaneous electrical nerve field stimulation compared to standard medical therapy in adolescents with functional abdominal pain disorders.

Gastrointestinal Group Education for Children and Adolescents with Functional Abdominal Pain Disorders—A Feasibility Study of a Brief Intervention

Functional abdominal pain disorders are common and disabling in children, but treatment options are limited. In a pilot study, we aimed to investigate if a brief group education program for pediatric patients with functional abdominal pain disorders and their parents is feasible and acceptable. Group education in adult irritable bowel syndrome has shown large treatment effects, but it has not been evaluated in children. The gastrointestinal (GI) group education, delivered in the clinic to 23 child–parent dyads, consisted of lectures by a pediatric gastroenterologist, a psychologist, and a dietician. Validated digital questionnaires were filled in by children and parents before and after the intervention. Most participants in the GI group education attended all sessions, and credibility in treatment was deemed high. Children’s self-reported knowledge of functional abdominal pain disorders increased, and improvements in gastrointestinal symptoms were reported at the end of this study. Our findings indicate that group education for children and adolescents with functional abdominal pain disorders, and their parents, is acceptable and feasible and may improve symptoms. A brief group education program may be of benefit in the management of pediatric functional abdominal pain disorders in several cases and when the family needs more knowledge than can be provided in primary care.

Role of peripheral and tissue eosinophils and eosinophil cationic protein in pediatric inflammatory bowel disease.

Inflammatory bowel disease (IBD), eosinophilic gastrointestinal disease (EGID), and functional abdominal pain disorder (FAPD) present with nonspecific gastrointestinal (GI) symptoms clinically and also have some similarities in pathogeneses associated with eosinophils. Therefore, we aimed to evaluate the role of eosinophils in IBD compared to EGID and FAPD by investigating eosinophils in peripheral blood and GI tissue and eosinophil cationic protein (ECP). Pediatric patients with chronic GI symptoms who underwent endoscopic biopsies were enrolled. Complete blood cell counts, inflammatory markers, immunoglobulin E (IgE), serum ECP levels, and endoscopic and histopathologic findings were retrospectively reviewed. A total of 387 patients were included: 179 with EGID, 107 with IBDs, and 82 with FAPD. Peripheral absolute eosinophil count (AEC), total IgE, and serum ECP were significantly higher in both IBD and EGID than in FAPD (all p < 0.05). Statistically significant differences were noted among the three groups in tissue eosinophil counts in each segment of GI tract except for the esophagus (p < 0.05). Significant differences were observed in tissue eosinophil counts in the ascending, sigmoid colon, and rectum between EGID and IBD (p < 0.05). Peripheral and tissue eosinophils in the stomach and duodenum revealed positive correlation in both EGID and IBD (both p < 0.001). Elevated eosinophil-related markers, as well as increased tissue eosinophilic infiltration in the affected areas of the GI tract in both IBD and EGID compared to FAPD, suggest that eosinophils might play a common important role in the pathogeneses of both diseases.

Psychological distress and coping efficacy in children with disorders of gut-brain interaction.

Multiple psychological factors influence disorders of gut-brain interaction (DGBIs). We aimed to evaluate psychological distress in Colombian schoolchildren with and without DGBIs. We included children ages 8-18 years without organic medical conditions from largest regional public schools in Colombia. Children completed Spanish versions of Rome III diagnostic questionnaire for DGBIs, State Trait Anxiety Inventory for Children (STAIC), Children's Somatization Inventory (CSI), and a measure of coping efficacy. These data, demographic and socioeconomic characteristics, were compared between children with DGBIs and healthy peers. Exploratory analyses investigated differences between youth with symptoms of functional abdominal pain disorders (FAPDs) compared with healthy peers. Of 1496 children, 281 (mean age 12.9 ± 2.2 years, 49.8% females) self-reported criteria for DGBIs and 125 reported (44.5%) FAPDs. Children with DGBIs had higher trait anxiety, emotional sensitivity, somatization including GI, non-GI, pain-related, and non-pain-related subscales (p < 0.001 each) and lower coping efficacy (p = 0.02) compared to healthy peers. Females had higher trait anxiety and somatization (p = 0.04 and p = 0.005, respectively). State and trait anxiety and coping efficacy differed based on location in children with DGBIs (p = 0.02, p = 0.03, and p < 0.001, respectively). Children with FAPDs had higher trait anxiety (p = 0.02) and somatization (p < 0.001) compared to healthy youth. Children with DGBIs had higher anxiety, emotional sensitivity, and somatization, and lower coping efficacy compared with healthy youth. This highlights the importance of appraising psychological distress characteristics as well as incorporating conflict resolution, assertiveness training, and resilience building during the treatment of DGBIs.

ESPGHAN and NASPGHAN 2023 protocol for paediatric FAPD treatment guidelines (standard operating procedure)

IntroductionTo date, no international guidelines have been published for the treatment of paediatric functional abdominal pain disorders (FAPDs), subcategorised into functional abdominal pain–not otherwise specified (FAP-NOS), irritable bowel syndrome (IBS),...

Percutaneous electrical nerve field stimulation compared to standard medical therapy in adolescents with functional abdominal pain disorders.

Standard medical therapy (SMT) in children with functional abdominal pain disorders (FAPD) includes cyproheptadine and amitriptyline. While percutaneous electrical nerve field stimulation (PENFS) has shown benefit, no study has compared outcomes of PENFS to SMT. We aimed to examine changes in abdominal pain, nausea and disability before and after treatment and compare outcomes between treatments. The records of FAPD patients ages 11-21 years, treated with 4 weeks of PENFS, cyproheptadine or amitriptyline were reviewed. Outcomes were evaluated using validated questionnaires [Abdominal Pain Index (API), Nausea Severity Scale (NSS), and the Functional Disability Inventory (FDI)] at baseline and follow-up within 3 months (FU). Of 101 patients, 48% received PENFS, 31% cyproheptadine and 21% received amitriptyline. Median ages were 17 (15-19), 16 (15-18) and 15 (11-16) years respectively and the majority were females (75%, 90% and 52% respectively). In the PENFS group, API (p = 0.001), NSS (p = 0.059) and FDI (p = 0.048) were significantly lower at FU. API (p = 0.034) but not NSS and FDI (p > 0.05) decreased significantly at FU in the amitriptyline group. API, NSS and FDI did not change significantly with cyproheptadine at FU (p > 0.05). FU API scores were lower in PENFS vs. cyproheptadine (p = 0.04) but not vs. amitriptyline (p = 0.64). The FDI scores were significantly lower in the amitriptyline vs. cyproheptadine group (p = 0.03). Therapy with PENFS showed improvements in abdominal pain, nausea and disability while amitriptyline showed improvements in abdominal pain within 3 months of treatment. PENFS was more effective than cyproheptadine in improving abdominal pain. Amitriptyline improved disability scores more than cyproheptadine and showed promise for treatment. PENFS may be a good non-pharmacologic alternative for FAPD.

Advancing the Assessment and Treatment of Comorbid Pediatric Chronic Functional Abdominal Pain (CFAP) and Restrictive Eating Disorders.

The aim of this review is to heighten awareness of the association between chronic functional abdominal pain (CFAP) and restrictive eating disorders (ED) in adolescents. We describe current diagnostic practices and propose future research efforts to improve the assessment and treatment of comorbid CFAP and restrictive EDs. A narrative review of the literature on CFAP and EDs was performed using PubMed, JSTOR, ScienceDirect, and PsycINFO and the following search terms: 'restrictive eating disorders', 'chronic functional abdominal pain', 'chronic pain' 'treatment' 'diagnosis' and 'adolescents'. Published studies on restrictive EDs and CFAP from May 2008 to March 2023 were included. Ascribable to the overlap in etiology and symptom presentation, adolescents with chronic pain are significantly less likely to have their ED pathology promptly identified by providers compared to adolescents without comorbid chronic pain. This highlights the importance of the time sensitive and accurate identification of EDs in adolescents with CFAP. Overall, assessment methods are limited and EDs take longer to be identified in adolescents with comorbid CFAP. Future efforts should address diagnostic practices in pediatric settings and improve the communication among medical and mental health providers in order to promote the rapid and effective diagnosis and treatment of comorbid CFAP and EDs.

Cognitive behavioural therapy for functional abdominal pain disorders in children and adolescents: A systematic review of randomized controlled trials

AimAlthough Cognitive behavioural therapy (CBT) potentially holds efficacy in addressing functional abdominal pain disorders (FAPDs) amongst children and adolescents, the persistent efficacy is uncertain. MethodsWe searched three databases to identify related randomized controlled trials (RCTs). Meta-analysis was performed using RevMan and Stata. Subgroup analyses were mainly conducted based on follow-up time. The GRADE approach was used to evaluate the certainty of the evidence. ResultsA total of 14 RCTs evaluating 858 patients were included. All RCTs were rated as having a high risk of bias. Compared with control groups, CBT was associated with improvement of general functional impairment (standardized mean difference (SMD) = -0.77, 95% CI [-1.12, −0.42], p < 0.05), higher treatment success (relative risk (RR) = 2.35, 95% CI [1.50, 3.69], p < 0.05), improvement of abdominal pain symptoms (SMD = −0.48, 95% CI [-0.73, −0.23], p < 0.05), QoL (SMD = 0.42, 95% CI [0.20, 0.64], p < 0.05), and psychological states (SMD = −0.95, 95% CI [-1.62, −0.27], p < 0.05). ConclusionThis meta-analysis provides low to moderate quality evidence that CBT could significantly improve clinical outcomes and QoL for children and adolescents with FAPDs with improvement persisting until short-term follow-up. However, there were discrepancies regarding CBT's effects at mid- and long-term follow-up across different outcomes. More high-quality and longer-duration studies are thus warranted to explore the effectiveness of CBT in the future. Systematic review registration on prosperoCRD42022369353.

Functional Abdominal Pain Disorders in Children May Be Associated with Food Intolerance/Malabsorption.

Functional abdominal pain disorders (FAPDs) are among the most common types of chronic pain disorders in children. FAPD symptoms are characterized by chronic abdominal pain and changed bowel movements. The pathophysiology of FAPDs in children is unknown, but these conditions may have an imprecise clinical overlap to food intolerance/malabsorption. We report on 51 consecutive children (23/28 males/females; median age 15.3 years) with investigated FAPDs from 2017 to 2022 in this retrospective pilot study. Small intestinal biopsies in children demonstrated the association of lactase and diamine oxidase (DAO), which prompted us to perform hydrogen (H2) breath tests for lactose intolerance (LIT) and determine serum DAO for the evaluation of histamine intolerance (HIT) in pediatric patients with FAPDs. To complete the food intolerance/malabsorption evaluation tests, we included a search for antibodies against tissue transglutaminase to find celiac disease (CD), performed H2 breath tests to detect fructose malabsorption (FM), and conducted a search for IgA antibodies against H. pylori infection. The results demonstrate that all 51 children evaluated were diagnosed with food intolerance/malabsorption and/or various combinations thereof. Seven children showed FM, eight of the children had HIT, and eight children had LIT. The other children had combinations: thirteen children (25.5%) had HIT and LIT, seven children (9.8%) had FM with HIT, five children (13.7%) had FM and LIT, and three children (5.9%) had a triple combination of FM, HIT, and LIT. By describing this method of personalized investigation for food intolerance/malabsorption in children with FAPDs, we demonstrate that functional abdominal pain disorders may be associated with food intolerance/malabsorption. After such diagnosis in this pediatric population, a registered dietitian helped to establish a reduction and/or exclusion diet individually tailored to their symptomatology.

Assesment of functional gastrointestinal diseases in obese children.

FGID in obese children was found to be increased significantly. Assessment of functional gastrointestinal symptoms in obese children will prevent unnecessary examinations. • Functional gastrointestinal disorders are reported to be more common in obese individuals. • Functional abdominal pain disorders and functional defecation disorders were significantly more common in obese children than non-obese group. • Constipation-predominant irritable bowel syndrome (IBS), diarrhea-predominant IBS, functional diarrhea, and abdominal distention were significantly more common in obese children than non-obese children.

A New Experimental Design to Examine Cognitive Biases for Gastrointestinal Related Stimuli in Children and Adolescents.

Cognitive biases toward disorder-specific stimuli are suggested as crucial to the development and maintenance of symptoms in adults with functional gastrointestinal disorders (FGID). Functional abdominal pain disorders (FAPD), a subtype of FGID, are common in children and adolescents, but the influence of cognitive biases is sparsely examined. This study aimed to (1) develop a new experimental design for assessing cognitive biases toward gastrointestinal stimuli in children and adolescents (aged 8 to 17 years) and (2) derive comparative data on bias toward gastrointestinal stimuli using a healthy "normative" sample. The online experimental design-BY-GIS (Bias in Youth toward GastroIntestinal-related Stimuli)-includes a word task and a picture task. Stimuli in both tasks are related to general and gastrointestinal symptoms, and the design includes three phases: (1) encoding, (2) free recall, and (3) recognition. Data were collected between April 2022 and April 2023 from 96 healthy participants (Mage = 12.32, 47.92% female). Adolescents were significantly better at recalling words than children (p = 0.03), whereas there were no significant gender or age differences with regard to recalling pictures (p > 0.05). Across age and gender, participants performed above chance level in the recognition phases of both tasks. The results support that the design is suitable within the age span.

The Use of Pictograms in the Evaluation of Functional Abdominal Pain Disorders in Children

To evaluate whether the use of pictograms improves symptom evaluation for children with functional abdominal pain disorders (FAPDs). This survey study was conducted in 2 academic centers and included patients aged 8-18years visiting the outpatient clinic for FAPD symptom evaluation. Patients were randomized to fill out the questionnaire without or with accompanying pictograms to assess gastrointestinal symptoms. Afterwards, patients underwent clinical health assessment by the healthcare professional (HCP). Subsequently, the HCP filled out the same questionnaire without pictograms, while blinded to the questionnaire completed by the patient. Primary outcome was the level of agreement between identified symptoms as assessed by patients and HCP. We included 144 children (questionnaire without accompanying pictograms [n=82] and with accompanying pictograms [n=62]). Overall agreements rates were not significantly different (without pictograms median, 70% vs with pictograms median, 70%). Accompanying pictograms did not significantly improve the assessment of abdominal pain symptoms. Accompanying pictograms were beneficial for concordance rates for nausea and vomiting symptoms (without pictograms median, 67% vs with pictograms median, 100%; P=.047). Subgroup analyses for children aged 8-12years of age revealed similar results (concordance on the presence of nausea and vomiting without pictograms median, 67% vs with pictograms median, 100%; P=.015). Subgroup analyses for children ages 12-18years showed no significant differences in concordance rates. Pictograms do not seem to improve the assessment of FAPDs. However, the use of pictograms improves the evaluation of nausea and vomiting, especially for children aged 8-12years. Therefore, HCPs could consider using pictograms in that setting during consultations.

Do Polymorphisms Predict Hypnotherapy Response in Children With Functional Abdominal Pain Disorders: An Explorative Study.

Genetic variations, in specific COMT , OPRM1 , and MAO-A polymorphisms, have been associated with hypnotizability in adults. The aim of this exploratory study was to investigate whether these polymorphisms are also associated with response to hypnotherapy (HT) in children. Patients (8-18 years, n = 260) diagnosed with a functional abdominal pain disorder (FAPD) from a previous trial assessing HT efficacy were approached for participation and 144 agreed to collect a buccal sample. Primary aim was to explore the association between COMT , OPRM1 , and MAO-A polymorphisms with treatment success (TS) after 3-month HT. Additionally, associations between these polymorphisms and adequate relief, anxiety, depression, quality of life, somatization, hypnotic susceptibility, expectations, pain beliefs, and coping strategies were evaluated. Participants with different variations of COMT , MAO-A , and OPRM1 achieved similar TS levels ( P > 0.05). No associations were found between these polymorphisms and secondary outcomes. This suggest that in pediatric patients with FAPDs, COMT , OPRM1 , and MAO-A polymorphisms do not predict HT response.

Functional abdominal pain disorders in children in southern Anhui Province, China are related to academic stress rather than academic performance

BackgroundFunctional abdominal pain disorders (FAPDs) are one of the most common gastrointestinal disorders in children. The aim of this study was to investigate the prevalence of FAPDs in children in southern Anhui Province, China and their association with academic stress.MethodsIn this cross-sectional survey, we randomly selected children aged 6–17 years from 11 public schools in southern Anhui Province. FAPDs were diagnosed according to the Rome IV criteria, and a custom-designed questionnaire was used to investigate the association between academic stress and FAPDs in children.ResultsA total of 2,344 children aged 6–17 years were enrolled. The mean age was 12.4 ± 3.0 years. Of these children, 335 (14.3%) were diagnosed with FAPDs according to the Rome IV criteria. Among the children with FAPDs, 156 (46.6%) were boys, and 179 (53.4%) were girls. The prevalence was higher in girls than in boys. The most common disorder was irritable bowel syndrome (IBS) (n = 182 (7.8%)). Other types of FAPDs included functional abdominal pain–not otherwise specified (FAPNOS) (n = 70 (3.0%)), functional dyspepsia (FD) (n = 55 (2.3%)), and abdominal migraine (AM) (n = 28 (1.2%)). Academic stress, not meeting parental expectations, poor relationships with parents, and sleep disturbances were independent risk factors for FAPDs in children; academic performance was not associated with the development of FAPDs.ConclusionThere was a high prevalence of FAPDs among children in southern Anhui Province, China, and IBS was the most common subtype of functional abdominal pain. Academic stress, rather than academic performance, was associated with FAPDs in children.

What are the effects of probiotics for the management of functional abdominal pain disorders in children?

What are the effects of probiotics for the management of functional abdominal pain disorders in children?

Non-pharmacologic approaches to treatment of pediatric functional abdominal pain disorders.

Functional abdominal pain disorders (FAPDs) affect up to 25% of children in the United States. These disorders are more recently known as disorders of "brain-gut" interaction. The diagnosis is based on the ROME IV criteria, and requires the absence of an organic condition to explain the symptoms. Although these disorders are not completely understood, several factors have been involved in the pathophysiology including disordered gut motility, visceral hypersensitivity, allergies, anxiety/stress, gastrointestinal infection/inflammation, as well dysbiosis of the gut microbiome. The pharmacologic and non-pharmacologic treatments for FAPDs are directed to modifying these pathophysiologic mechanisms. This review aims to summarize the non-pharmacologic interventions used in the treatment of FAPDs including dietary modifications, manipulation of the gut microbiome (neutraceuticals, prebiotics, probiotics, synbiotics and fecal microbiota transplant) and psychological interventions that addresses the "brain" component of the brain-gut axis (cognitive behavioral therapy, hypnotherapy, breathing and relaxation techniques). In a survey conducted at a large academic pediatric gastroenterology center, 96% of patients with functional pain disorders reported using at least 1 complementary and alternative medicine treatment to ameliorate symptoms. The paucity of data supporting most of the therapies discussed in this review underscores the need for large randomized controlled trials to assess their efficacy and superiority compared to other treatments.

Celiac Disease and Disorders of Gut-Brain Interaction: What School Nurses Need to Know.

Abdominal pain and discomfort are common reasons students visit the school health office. Abdominal pain, in children, may be related to gastrointestinal conditions such as celiac disease (CD) or disorders of gut-brain interaction (DGBIs). Both CD and DGBIs, formerly known as functional abdominal pain disorders, are both prevalent in the pediatric population. Manifestations, presentation, and management of these disorders overlap and will be reviewed in this article. Due to their chronic nature, school nurses should be aware of both the management and complications associated with CD and DGBIs. Dietary recommendations, including the gluten-free and low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPS) diet, will be presented as part of the management of the disorders.

0783 Sleep Continuity and Quality in Adolescents with Functional Abdominal Pain

Abstract Introduction Functional Abdominal Pain Disorders (FAPD), in which chronic abdominal pain occurs independently of organic pathology, are common in adolescents. FAPD can lead to significant impairment in daytime function and may overlap with sleep disorders. Though several studies have explored the nature of sleep disturbances experienced by adolescents with FAPD, none have characterized differences in sleep architecture in this population. Methods Adolescents (age 11-18 years) with FAPD and age/gender-matched controls were prospectively recruited to undergo polysomnography (PSG). PSG was performed according to AASM guidelines, scored by a registered sleep technologist, and interpreted by a board-certified sleep physician. The first four hours of artifact-free NREM sleep were analyzed using fast Fourier transformation with Welch tapered windows of 1024 samples (and 50% overlap) averaged over 30-second epochs. Total power was calculated for very low (0.3 – 1 Hz), delta (1 – 4 Hz), theta (4 – 8 Hz), and alpha (8-12 Hz) frequencies. Comparisons between groups were made using Wilcoxon rank sum tests or t-tests for non-normal and normal data, respectively. Results A total of 41 subjects were recruited (FAPD n=21, control n=20). The FAPD group had a greater arousal index and a lower percentage of NREM 3 sleep when compared to the control group (FAPD arousals: mean=10.08/min ± 4.89 min, control arousals mean=7.31/min ± 3.61/min, p = 0.046), FAPD NREM 3: mean=20.13% ± 5.47%, control NREM 3: mean=24.77% ± 6.94%, p =0.023). Delta power was significantly lower in the FAPD group compared to controls (FAPD Delta mean=488.67 µV2 ± 282.82 µV2, control Delta mean=1193.14 µV2 ± 663.89 µV2, p &amp;lt; 0.001). Conclusion This study demonstrates significant differences in sleep architecture of adolescents with FAPD compared to their peers. In particular, decreased proportions of NREM 3 sleep and lower Delta power are indicative of diminished slow wave sleep (SWS). Reductions in SWS may be indicative of common neurotransmitter pathways shared between sleep and chronic pain syndromes, or secondary to sleep disruption associated with pain. Further research is indicated. Support (if any) This research is supported by the Cincinnati Children’s Research Foundation and the Summer Medical Student Respiratory Research Fellowship program at Cincinnati Children’s.