Sleep quality and efficiency in adolescents with chronic pain: relationship with activity limitations and health-related quality of life

The primary purpose of this report was to test hypothesized relationships among poorer sleep quality, increased activity limitations, and reduced health-related quality of life (HRQOL) in adolescents with and without chronic pain. Forty adolescents (20 with chronic pain, 20 healthy) completed measures of HRQOL, activity limitations, pain, depression, and sleep quality. Actigraphy was completed over 7 days. Correlational analyses demonstrated significant relationships where poorer subjective sleep quality was associated with greater activity limitations and reduced HRQOL. Lower actigraphic sleep efficiency was associated with greater activity limitations. In multiple regression analyses, frequency of pain predicted activity limitations and HRQOL. Controlling for pain and depression, lower sleep efficiency was a significant predictor of greater activity limitations but not of HRQOL. Adolescents with chronic pain would benefit from thorough assessment and treatment of sleep disturbances, as alleviation of sleep complaints might enhance HRQOL and physical functioning in this population.     

Sleep patterns in female adolescents with chronic musculoskeletal pain

This study examined sleep patterns in female adolescents with chronic musculoskeletal pain. Twenty-six participants with chronic musculoskeletal pain completed questionnaires during their clinic visit, and three 24-Hour Sleep Patterns Interviews during the following 2 weeks. Compared to normative data (Acebo & Carskadon, 2002), adolescents with chronic pain reported similar total sleep time (TST) and bedtimes. However, study participants reported significantly longer sleep onset latency, more night wakings, a later morning wake time, and more symptoms of daytime sleepiness. Pain improved after sleep for 27% of the study sample, and was associated with longer TST. Finally, depression and anxiety were related to daytime sleepiness, but not total sleep time or sleep onset latency. Female adolescents with chronic pain either may be more sensitive to the chronic sleep debt that is common in this age group, or they may experience underlying physiological sleep disrupters (e.g., periodic limb movement disorder) or sleep abnormalities (e.g., alpha-delta intrusions) not measured in this study. Additional research is needed to examine the complex relation between sleep and chronic musculoskeletal pain.     

正常青少年及青少年特发性脊柱侧凸患者枕颈部矢状面形态相关研究

目的比较正常青少年与青少年特发性脊柱侧凸（AIS）患者枕颈矢状面形态,探讨其枕颈矢状面形态与颈椎矢状面形态相关性。方法收集2012年3月—2014年3月在南京鼓楼医院脊柱外科入院治疗并符合入选标准的AIS患者80例（男14例,女66例）作为AIS组;正常青少年志愿者100名（男17名,女83名）作为对照组。在枕颈部侧位X线片上测量并记录枕骨入射角（OI）、枕骨斜率（OS）、枕骨倾斜角（OX）、上颈椎前凸角（C0-C2）、下颈椎前凸角（C2-C7）和颈椎前凸角（C0-C7）,比较对照组与AIS组枕颈参数差异及其与年龄、性别的关系,并分析枕颈参数与颈椎矢状面形态相关性。结果对照组OI、OS和OT分别为36．12°±2．55°（30°～44°）、26．34°±8．41°（15°-46°）和-10．06°±7．51°（-22°～11°）,AIS组OI、OS和OT分别为35．62°±3．01°（31°～42°）、24．27°±8．49°（7°-42°）和-11．52°±9．23°（-28°-10°）,两组枕颈部形态参数差异均无统计学意义（t分别为0．878、1．014、1．306,P值均〉0．05）,且不受年龄（≤14岁,〉14～18岁）、性别影响（P值均〉0．05）。对照组OI与C0-C2角和C0-C7角显著相关（r=0．307和r=0．298,P值均〈0．05）,OS和OT分别与C2-C7角和C0-C7角显著相关（r=0．402和r=0．560、r=0．428和r=0．550,P值均〈0．05）;而AIS组仅OI和OS与C0-C2角存在显著相关性（r=0．532和r=0．620,P值均〈0．05）。结论正常青少年和AIS患者的枕颈参数无显著差异,且不受年龄与性别影响。正常青少年OI、OS和OT与颈椎矢状面形态显著相关,而AIS患者枕颈部矢状面形态仅与其上颈椎矢状面形态密切相关。     

中文版青少年癫痫患者生活质量问卷信度及效度检验

目的：将英文版青少年癫痫患者自陈式生活质量调查问卷（QOLIE-AD-48）翻译为中文,并检验其信度、效度及敏感度。方法：信度指标包括内部一致信度及重测信度．效度指标包括聚合及判别效度、结构效度。敏感度分析通过比较不同发作严重程度总分的差异是否显著来评价。结果：聚合／判效度结果显示,分量表内的何道题目与所在分量表的相关系数在0．4以上,每一题目与所在分量表的相关性高于其他分量表。总分内部一致信度为0．93,分量表在0．60～0．91之间,总分重测信度为0．76。总分随发作严重程度的增加而显著下降,敏感度良好。结论：QOLIE-AD-48中文版具有良好的效度、信度及敏感度,可以胜任中国青少年癫痫患者健康相关生活质量研究所需。     

Sleep problems and depressed mood negatively impact health-related quality of life during pregnancy

The objectives of this study were to evaluate and identify determinants of health related quality of life (HRQoL) during pregnancy. Pregnant women (n = 245) completed questionnaires measuring: HRQoL (Short Form Health Survey SF-36), life stress, social support, sleep, and depressed mood in the third trimester. Demographics and medical variables were also collected. Compared to Canadian normative data, our sample scored significantly poorer on the following HRQoL domains: physical functioning, role limitations due to physical health problems, bodily pain, vitality, and social functioning. Multivariate linear regressions were used to model each of the SF-36 subscales. Experiencing sleep problems emerged as a significant determinant of poorer HRQoL in all domains, with the exception of emotional role. Higher depressed mood scores was independently associated with lower HRQoL in six of the eight domains, including bodily pain, general health, vitality, social functioning, emotional role, and mental health. Greater pregnancy-related anxiety was independently associated with lower scores on physical functioning and role limitations due to physical health problems. Women experience lower HRQoL during pregnancy, particularly in the physical domains. The importance of identifying and managing modifiable determinants early in pregnancy to enhance maternal health status is discussed.     

青少年特发性脊柱侧凸矫形术后并发感染对患者手术疗效及生存质量影响研究

目的 探讨青少年特发性脊柱侧凸术后并发感染对患者手术疗效及生存质量影响的研究.方法 收集2007年1月～2007年12年在我院行脊柱侧凸矫形手术的AIS患者210例,按术后发生与未发生感染将患者分为2组,术后随访时间大于2年.详细分析患者的病历资料,包括手术前后及随访时的放射学参数、手术中数据及患者填写SRS-22量表结果,将两组患者的各项数据进行相应的统计学检验,以P<0.05作为检验标准.结果 210例忠者中,9人发生感染(4.2%),3例发生急性感染(术后15天),6例发生迟发性感染(半均35.2个月),临床表现以背部疼痛7例)、局部肿胀(5例),及切口渗液(4例)为主.5例感染忠者行外科置管冲洗、清创及内固定物移除术治疗,2例患者最终行内固定物移除术治疗,术后4～8周静脉应用抗生素治疗,感染组术后矫正率低于未感染组(P<0.05),SRS-22量表填写结果在疼痛、功能、自我形象、心理健康四个维度得分两组间无明显统计学意义(P>0.05).患者治疗满意度维度感染组得分低于未感染组(P<0.05).结论 脊柱侧凸矫形术后感染并发症可经外科置管冲洗、清创、内固定物移除术及静脉应用抗生素治愈,术后感染发生导敛原有矫止率丢失,患者对治疗满意度降低.     

Sleep and quality of life of patients with glycogen storage disease on standard and modified uncooked cornstarch

Background

Glycemic control in hepatic glycogen storage diseases (GSDs) relies on specific nutritional recommendations, including strict avoidance of a fasting period. Uncooked cornstarch (UCCS) is an important therapeutic component. A new modified UCCS, Glycosade?, was created with the objective of prolonging euglycemia. We aimed to determine the length of euglycemia on Glycosade? using a continuous glucose monitor (CGM) and to evaluate whether longer euglycemia and thus less nighttime interruptions would improve sleep and quality of life (QoL) after the introduction of the modified cornstarch.

Effects of Sleep Deprivation on Memory and Sleep Latencies in Connection with Repeated Awakenings From Sleep

Twelve subjects were kept awake 64 hrs. During baseline and recovery sleep, subjects were given a simple memory task. The subjects were awakened 3 times each night during slow-wave sleep and shown 4 playing cards. Approximately 90 min later the subjects were again awakened and tested for retention of the previous cards and given 4 new cards to learn. This procedure was repeated 3 times each night and upon awakening the following morning. On the recovery night recall was reduced, slow-wave sleep was lengthened, sleep latency was shortened, and body motility was reduced. It was suggested that the reason for the poorer recall was deeper sleep induced by the sleep deprivation.     

Clinical profile, health-related quality of life, and asthma control in children attending US asthma camps.

BACKGROUND: Approximately 120 asthma camps presently serve nearly 10,000 children nationwide. A clinical profile of the children who attend asthma camps has not been published. OBJECTIVES: To create a standardized universal health history camp application that includes an assessment of health-related quality of life using the Child Asthma Short Form; to test a newly validated tool, the Childhood Asthma Control Test (C-ACT), to assess asthma control in children; to provide a clinical snapshot of the overall status of children with asthma in the United States; and to determine the benefit of children's asthma camps. METHODS: Participating camps distributed the universal health history and the Child Asthma Short Form as part of their application. The C-ACT was distributed separately. RESULTS: A total of 1,783 campers from 24 camps in 17 states provided the requested information. Camp attendees generally had moderately severe asthma, as indicated by a mean +/- SD parent-reported severity rating of 4.86 +/- 2.10 on a 10-point scale. Average daytime and nighttime symptom scores and functional limitation scores indicated children moderately burdened by their asthma symptoms. Using the C-ACT, 37% of children were found to have inadequately controlled asthma. Children who had attended asthma camp the previous year reported better use of asthma management tools, were more likely to be using controller therapy, and had more responsibility for taking their medication (P < .05). CONCLUSION: The burden of asthma experienced by children attending asthma camps is substantial, suggesting that there is an opportunity to improve the lives of children attending asthma camps.     

Sleep and neurocognitive functioning in children with eczema

Sleep disruption in childhood is associated with clearly defined deficits in neurocognition and behaviour. Childhood eczema is also a potent cause of sleep disruption though it is unknown whether it too results in neurocognitive deficits. To test this hypothesis, neurocognitive (WISC-IV), parental-reported sleep quality (Sleep Disturbance Scale of Children (SDSC)) and overnight polysomnographic (PSG) data were collected in 21 children with eczema and 20 healthy controls (age range 6–16 years). Children with eczema had worse sleep quality on both PSG (notably increased nocturnal wakefulness, a higher number of stage shifts and a longer latency to REM onset) and parental report. In addition, they demonstrated significant neurocognitive deficits (especially verbal comprehension, perceptual reasoning and to a lesser extent working memory) with a composite Full Scale IQ 16 points lower than controls. Parental reported sleep problems but not PSG parameters were correlated with reduced neurocognitive performance. However, hierarchical regression analyses revealed that eczema status was predictive while sleep fragmentation (parental or PSG) was not predictive of neurocognitive performance. As this is the first study to systematically examine neurocognitive functioning in children with eczema and given the finding of significant deficits it merits replication especially given the prevalence of the condition. The unanswered question is whether these cognitive deficits normalise with effective eczema treatment and if this is mediated by improvements in sleep architecture.     

Effect of Cancer-Related Dysfunctional Beliefs About Sleep on Fear of Cancer Progression in the Coronavirus Pandemic

BackgroundThis study aimed to explore clinical correlates of fear of progression (FoP) among patients with cancer during the coronavirus disease 2019 (COVID-19) pandemic and examine the mediation effect of cancer-related dysfunctional beliefs about sleep (C-DBS).MethodsMedical charts of patients with cancer who visited a psycho-oncology clinic between July and November 2021 were reviewed. Baseline socio-demographic and cancer-related variables were collected. Patients’ self-report questionnaires, regarding FoP, depression (Patient Health Questionnaire-9 items; PHQ-9), viral anxiety (Stress and Anxiety to Viral Epidemics-6 items; SAVE-6), C-DBS, and other distress, were investigated. Pearson’s correlation and linear regression were performed to examine the risk factors of FoP. Mediation effect analysis with the bootstrap method with 2,000 resamples was implemented.ResultsA total of 231 patients were included in the analysis. Linear regression revealed that FoP was predicted by age (β = −0.14, P = 0.003), PHQ-9 (β = 0.48, P < 0.001), SAVE-6 (β = 0.34, P < 0.001), and C-DBS (β = 0.15, P = 0.005). FoP was directly influenced by SAVE-6 and mediated by C-DBS, while it was directly influenced by PHQ-9 with no mediation effect.ConclusionDuring the COVID-19 pandemic, the FoP of patients with cancer was associated with younger age, depression, viral anxiety, and C-DBS. Depression and viral anxiety directly influenced FoP, while C-DBS mediated the association between viral anxiety and FoP. Therefore, oncology healthcare professionals are recommended to assess C-DBS of their patients when they are highly distressed from FoP.     

Parent-reported sleep problems in children and adolescents with sickle cell disease: relationship to health-related quality of life

IntroductionChildren with sickle cell disease (SCD) can present a variety of clinical symptoms that may affect their sleep and health-related quality of life (HRQOL). This study aims to investigate the relation between sleep problems and HRQOL in children and adolescents with SCD.Material and methodsThe sample included 86 children and adolescents in the SCD patient group and 82 healthy controls, with an age range of 8–16 years. Subjects for the study were recruited from the Sickle Cell and Thalassemia Center of Hatay State Hospital, Hatay, Turkey. The Children’s Sleep Habits Questionnaire (CSHQ) was used to evaluate sleep problems and Kinder Lebensqualitätsfragebogen: Children’s Quality of Life Questionnaire – revised (KINDL-R) was used to examine HRQOL.ResultsTotal score, bedtime resistance, and night waking subscores of CSHQ were significantly higher in children with SCD when compared to healthy children. Total score, physical well-being, emotional well-being, social, and school subscores of KINDL-R were significantly lower in the patient group. Among SCD children, total score, bedtime resistance, sleep onset delay, daytime sleepiness, and parasomnias subscores of CSHQ were negatively correlated with KINDL-R total score. In the regression model, disease severity and CSHQ total score had significant negative associations with KINDL-R total score.ConclusionsSleep problems in SCD children appear to be negatively linked with HRQOL. Disease severity and sleep problems may be predictors of overall HRQOL in children and adolescents with SCD.     

Quality of life of adolescents with type 1 diabetes

INTRODUCTION:

Diabetes mellitus is a highly prevalent chronic disease. Type 1 diabetes mellitus usually develops during infancy and adolescence and may affect the quality of life of adolescents.

OBJECTIVE:

To evaluate the quality of life of adolescents with type 1 diabetes mellitus in a metropolitan region of western central Brazil.

METHODS:

Adolescents aged 10–19 years who had been diagnosed with type 1 diabetes mellitus at least 1 year previously were included. Patients with verbal communication difficulties, severe disease, and symptomatic hypo- or hyperglycemic crisis as well as those without an adult companion and who were <18 years of age were excluded. The self-administered Diabetes Quality of Life for Youths instrument was applied.

RESULTS:

Among 96 adolescents (57% females; 47% white, and 53% nonwhite), 81% had an HbA1c level of >7%. In general, the adolescents consistently reported having a good quality of life. The median scores for the domains of the instrument were as follows: “satisfaction”: 35; “impact”: 51; and “worries“: 26. The total score for all domains was 112. Bivariate analysis showed significant associations among a lower family income, public health assistance, and insulin type in the “satisfaction” domain; and a lower family income, public health assistance, public school attendance, and a low parental education level in the “worries“ domain and for the total score. A longer time since diagnosis was associated with a lower total score. Multivariable analysis confirmed the association of a worse quality of life with public health assistance, time since diagnosis, and sedentary lifestyle in the “satisfaction” domain; female gender in the “worries” domain; and public health assistance for the total score.

CONCLUSIONS:

Overall, the adolescents evaluated in this study viewed their quality of life as good. Specific factors that led to the deterioration of quality of life, including public assistance, time since diagnosis, sedentary lifestyle, and female gender, were identified.     

Sleep and EEG profile in neonatal hippocampal lesion model of schizophrenia

Sleep architecture, EEG power pattern and locomotor activity were investigated in a putative animal model of schizophrenia. The model was prepared by excitotoxic damage of the ventral hippocampus on postnatal day 7 (PD 7), after which locomotor activity and electroencephalographic (EEG) sleep profile were compared between lesioned and sham operated animals respectively, at prepuberty (postnatal day PD 35) and postpuberty (PD 56). An enhancement of locomotor activity was observed in lesioned adult PD 56, but not in juvenile PD 35 rats. Spontaneous EEG/EMG recordings during 24 h showed no major differences between both groups at PD 35 and at PD 56. However, quantitative analysis of the EEG revealed an enhancement of power in delta (delta), theta (theta) and alpha (alpha) activities in lesioned animals at PD 35 during wakefulness in both light and dark phases. At PD 56, the power in the delta and theta bands was increased during the light and dark periods in both wakefulness and non-REM sleep. These findings suggest that ventral hippocampus lesion is not associated with disturbance of sleep architecture in rats, while consistent changes were observed in the dynamic of EEG slow wave frequency domain. Thus, the data indicate that neonatal lesion of ventral hippocampus did not mimic sleep abnormalities observed in schizophrenia, however this rodent model may model some EEG features seen in schizophrenia such as a frontally pronounced slowing of the slow EEG activity in delta and theta frequency bands.     

学生睡眠质量及其相关因素

本研究应用匹兹堡睡眠质量指数（ＰＳＱＩ）调查了５６０名学生。研究发现学生ＰＳＱＩ平均得分为５．２６±２．３８，１３．９３％的学生有睡眠质量问题，男生显著高于女生（１８．０１％ｖｓ８．４０％ｘ￣２＝１０．５４，Ｐ＜０．０１）。逐步回归分析揭示影响学生睡眠质量问题的主要危险因素依次为抑郁分（ＳＤＳ）、生活事件、焦虑分（ＳＡＳ）、睡觉迟、健康状况差、男性和体育活动少。     

大学生睡眠质量与心理健康状况的相关性研究

本研究应用匹兹堡睡眠质量指数（ＰＳＱＩ）和症状自评量表（ＳＣＬ－９０）探讨了大学生睡眠质量与心理健康的关系。结果显示，５６０名大学生中１３．９３％的人睡眠质量较差，男生显著高于女生（１８．０１％ＶＳ８．４％，Ｐ＜０．０１）。对ＳＣＬ－９０各因子分析发现７．０～２７．９％的学生有不同程度的心理健康问题。相关分析表明ＰＳＱＩ与ＳＣＬ－９０各因子及其总均分皆呈显著的正相关。睡眠质量差的学生ＳＣＬ－９０各因子平均分和现患率显著高于睡眠质量好的学生。     

Chronic pain and its impact on quality of life in adolescents and their families

OBJECTIVE: To study chronic pain not caused by somatic disease in adolescents and the effect of pain on the quality of life of the adolescents and their families. METHODS: One hundred twenty-eight youngsters (12-18 years) who had reported chronic pain kept a 3-week diary of their pain and completed a questionnaire on quality of life. Their mothers completed a questionnaire on the impact of their youngster's pain on the family. RESULTS: The most prevalent pains were limb pain, headache, abdominal, and back pain. The pain increased during the day, with the highest frequency around dinner time and the highest intensity around bedtime. Girls reported more intense and more frequent pain than boys. The higher the intensity and frequency of the pain, the lower the self-reported quality of life of the female or male adolescent, especially regarding psychological functioning (e.g. feeling less at ease), physical status (a greater incidence of other somatic complaints), and functional status (more impediments to leisure and daily activities). Chronic pain also had a negative impact on family life. The mothers reported restrictions, particularly in social life, and problems dealing with the stress of the adolescent's pain. CONCLUSIONS: Chronic pain, not caused by somatic disease, was present to a higher degree in girls; the pain increased during the day and had a negative impact on quality of life of the adolescents and the family. There is a need for future research aimed at identifying risk factors for chronic pain and pain-associated quality of life in children and adolescents.