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Sleep Improves Pain and PTSD Symptoms in Youth

Sleep quality partially mediates the relationship between PTSD and pain in children and adolescents, according to new research reported in The Journal of Pain, published by the American Pain Society.

Trauma, caused by neglect, threats of death or injury or sexual violence, is prevalent among American youth. It is estimated that one in four American children and adolescents experience at least one traumatic event by age 16, and more than 60% have experienced a traumatic event during adolescence. PTSD in childhood and adolescence can have long-term consequences. Studies have linked early-life trauma and PTSD to poor health in adulthood.

Previous research has shown that children and adolescents with chronic pain have higher rates of PTSD compared to those without PTSD. However, evidence suggests that poor sleep is not just a secondary symptom of PTSD but a risk factor for worsening symptoms of the disorder.

A multicenter team of Canadian and American researchers hypothesized that that poorer sleep quality would mediate the association between higher PTSD, greater pain intensity, and interference with daily activities in youth with chronic pain.

For the study, 97 children and adolescents with chronic pain were recruited from specialty chronic pain clinics at two tertiary care children's hospitals in the northwestern United States. In questionnaires, the study subjects rated their pain intensity and location, pain interference, anxiety symptoms and PTSD measured by reporting traumatic or distressing events. Also, a 10-item questionnaire was used to measure sleep quality. The study is the first to examine sleep quality as a potential modifiable mechanism underlying the association between PTSD and chronic pain in children and adolescents.

Results showed that sleep quality partially mediated the PTSD-chronic pain and PTSD-pain interference relationships. Among youth with chronic pain, higher PTSD was associated with higher levels of pain intensity and pain interference.

This relationship was partially explained by poor sleep quality. Sleep disturbance, according to the authors, is a key interpersonal factor driving the co-occurrence of pain and PTSD in youth.

The authors concluded their findings show that sleep is a modifiable factor that can be targeted in clinical interventions to help prevent pain and comorbid mental health problems from progressing into adulthood.

Source: American Pain Society