Study Objectives:

Sleep problems are highly comorbid with pediatric pain, yet there is a dearth of research on how pain and somatic complaints impact adolescent insomnia presentation and response to cognitive-behavioral therapy for insomnia (CBT-I). This study aims to (1) determine the prevalence of parent-reported somatic/pain complaints in adolescents with insomnia presenting to a behavioral sleep clinic, (2) assess the impact of somatic/pain complaints on initial sleep presentation, and (3) assess the impact of baseline somatic/pain complaints on response to CBT-I.

Methods:

Participants included adolescents (N=375) presenting to a behavioral sleep medicine center with a primary diagnosis of insomnia. As a part of clinical care, pre-evaluation measures were completed including the Pediatric Insomnia Severity Index (PISI), Adolescent Sleep Hygiene Scale, Adolescent Sleep Wake Scale, and Child Behavior Checklist (CBCL). The Somatic Syndrome Scale of the CBCL measured somatic complaints and teens were categorized as endorsing pain if reported to experience aches/pains, headaches, or stomachaches. Adolescents completed the PISI at end-of-treatment.

Results:

Most adolescents had parent-reported somatic (61.1%) and/or pain complaints: headaches (66.6%), stomachaches (48.5%), and aches/pains (45.1%). Greater somatic and pain complaints predicted a worse sleep presentation at intake (all p<.05). After controlling for insomnia severity at intake, end-of-treatment insomnia severity nor treatment status were predicted by somatic and pain complaints at intake.

Conclusions:

Results suggest that parent-reported somatic/pain complaints are prevalent in >50% of adolescents seeking behavioral insomnia treatment. Although complaints are associated with more severe insomnia at intake, they do not appear to interfere with treatment response.

中文翻译：

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在行为睡眠医学诊所就诊的失眠青少年躯体和疼痛主诉的发生率以及与睡眠障碍的关联

学习目标：

睡眠问题与儿科疼痛高度共存，但缺乏关于疼痛和躯体不适如何影响青少年失眠表现和对失眠认知行为疗法 (CBT-I) 的反应的研究。本研究旨在 (1) 确定在就诊于行为睡眠诊所的失眠青少年中父母报告的躯体/疼痛主诉的流行率，(2) 评估躯体/疼痛主诉对初始睡眠表现的影响，以及 (3) 评估基线躯体/疼痛主诉对 CBT-I 反应的影响。

方法：

参与者包括青少年 (N=375)，他们在行为睡眠医学中心就诊，初步诊断为失眠。作为临床护理的一部分，完成了预评估措施，包括儿童失眠严重程度指数（PISI）、青少年睡眠卫生量表、青少年睡眠觉醒量表和儿童行为检查表（CBCL）。CBCL 的躯体综合症量表测量了躯体症状，如果报告出现疼痛/疼痛、头痛或胃痛，青少年将被归类为背痛。青少年在治疗结束时完成了 PISI。

结果：

大多数青少年有父母报告的躯体 (61.1%) 和/或疼痛主诉：头痛 (66.6%)、胃痛 (48.5%) 和疼痛/疼痛 (45.1%)。更多的躯体和疼痛抱怨预示着摄入时睡眠表现更差（所有p <.05）。在控制摄入时的失眠严重程度后，治疗结束时的失眠严重程度或治疗状态可通过摄入时的躯体和疼痛投诉来预测。

结论：

结果表明，父母报告的躯体/疼痛投诉在 >50% 寻求行为失眠治疗的青少年中很普遍。尽管抱怨与摄入时更严重的失眠有关，但它们似乎不会干扰治疗反应。