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.