129) Sleep Changes in Adolescents with Chronic Pain Enrolled in Intensive Interdisciplinary Pain Treatment

Research demonstrates bi-directional associations between sleep difficulty and chronic pain, as well as relationships between sleep, daily function, and mental health. Adolescents with chronic pain frequently report difficulty falling and staying asleep, associated daytime fatigue, and decreased energy levels. However, few studies track both objective and subjective sleep changes in adolescents with chronic pain, and how these changes impact measures of daily functioning and mental health. This prospective longitudinal study followed 62 adolescents (53 female, age 13-17) through an intensive interdisciplinary pain treatment (IIPT) program consisting of daily intensive exercise, creative and relaxation-based coping, and psychological intervention. Prior to entering the program, all sleep medications besides melatonin were discontinued. Participants were assessed prior to the program, weekly throughout the program, and approximately one month after completion using actigraphy and self-report measures of sleep, fatigue, anxiety, depression, daily functioning, and pain. Paired samples t-tests were performed and accompanied by hierarchical linear modeling for longitudinal analyses. At baseline, patients were dissatisfied with their sleep (mean score 1.13, range 0-4) and reported difficulty falling asleep (mean 2.69, range 0-4), low energy (46/100) and high fatigue (T-score=63). Objective measures suggested adequate sleep efficiency (92%), but a 58-minute latency to persistent sleep. Statistically-significant improvements were observed at program end for sleep satisfaction, as well as difficulty falling asleep, energy level, and daytime fatigue, with continued improvement at the 2-week follow up (all P's