Sleep Moderating the Relationship Between Pain and Health Care Use in Youth With Sickle Cell Disease.
Sleep Moderating the Relationship Between Pain and Health Care Use in Youth With Sickle Cell Disease.
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DOI：
10.1097/ajp.0000000000000783
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发表时间：
2020-02
期刊：
影响因子：
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通讯作者：
Sisler I
中科院分区：
文献类型：
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作者：
Valrie CR;Alston K;Fuh B;Redding-Lallinger R;Sisler I
本研究的目的是调查睡眠对镰状细胞病（SCD）青年患者疼痛和医疗保健使用（HCU）之间关系的影响。据推测，睡眠不佳与较高的HCU有关，并将加强SCD青年中高疼痛频率与更多HCU之间的关系。96名SCD青少年（8-17岁）和他们的监护人，从三个地区的儿科SCD诊所招募。监护人使用父母结构化疼痛访谈报告了青少年的疼痛频率和HCU，青少年佩戴睡眠活动记录仪长达两周，以评估睡眠持续时间和睡眠效率。一系列回归模型计算了以下结果：急诊科就诊，住院和医疗保健提供者联系。与假设不一致，睡眠不好与HCU没有直接关系。此外，更长的睡眠时间似乎加强了高疼痛频率和更多艾德就诊之间的关系。研究结果表明，良好的睡眠可能是更好地将疼痛与HCU相匹配的保护因素。应在研究限制的背景下解释结果。未来的研究需要调查可能的机制，将睡眠时间与HCU联系起来，以应对疼痛，并确定睡眠模式是否会影响SCD青少年疼痛和其他功能结果之间的关系。在临床上，这些发现支持需要承认和解决睡眠在儿童人群中对SCD疼痛的反应中所起的作用。
The purpose of the current study was to investigate the influence of sleep on the relationship between pain and health care use (HCU) in youth with sickle cell disease (SCD). It was hypothesized that poor sleep would be related to higher HCU and would strengthen the relationship between high pain frequency and more HCU among youth with SCD. Ninety-six youth with SCD (aged 8–17 years), and their guardians, were recruited from three regional pediatric SCD clinics. Guardians reported on the youth’s pain frequency and HCU using the Structured Pain Interview for Parents, and youth wore a sleep actigraph for up to two weeks to assess sleep duration and sleep efficiency. A series of regression models were calculated with the following outcomes: emergency department visits, hospitalizations, and health care provider contacts. Inconsistent with hypotheses, poor sleep was not directly related to HCU. Also, higher sleep duration appeared to strengthen the relationship between high pain frequency and more ED visits. Findings suggest that good sleep may serve as protective factor for better matching pain to HCU. Results should be interpreted in the context of study limitations. Future research is needed to investigate possible mechanisms linking sleep duration to HCU in response to pain and to ascertain if sleep patterns influence the relationship between pain and other functional outcomes in youth with SCD. Clinically, these findings support the need to acknowledge and address the role that sleep plays in responding to SCD pain in pediatric populations.