Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Pain and Mood as Predictors of Sleep Quality in Children with Polyarticular Arthritis
Bromberg1, Maggie Hood, Gil1, Karen M., Anthony2, Kelly K., Schanberg3, Laura E.
Since pain and depressed mood are associated with sleep problems in children with chronic illness, we examined the role of mood and pain in predicting sleep quality in children with polyarticular arthritis.
The sample consisted of 51 children with polyarticular arthritis (31 girls; 84% Caucasian; mean age 12.4 years). All children were participating in a larger study that included a baseline assessment and daily reports of pain, mood, stress, coping and disease symptoms completed over a two month period, from which the present data were gathered. An active joint count and a physician global assessment (PGA) were completed by a pediatric rheumatologist at baseline. Children rated their current pain and sleep quality during the previous night on 100mm visual analogue scales. Daily mood was assessed via the Facial Affective Scale (FAS). Descriptive statistics were performed and daily reports were aggregated to produce an average score on each daily variable for each child. Following Pearson-product moment correlations, a hierarchical regression using the aggregate data was conducted to examine predictors of sleep quality.
Children had mild to moderate disease severity (mean PGA = 31.5mm) with active arthritis in 9 joints on average. Across the diary reporting period, children endorsed moderate to high sleep quality (mean = 75.3mm) and positive mood (mean FAS = 2.8). Correlations revealed no significant relationships between disease-related variables and sleep quality. Both aggregated pain (r =-.61, p <.0001) and mood (r =-.58, p <.0001) were highly correlated with sleep quality. Hierarchical regression revealed that both pain (²R2=.34, p <.0001) and mood (²R2=.14, p <.001) predicted a significant proportion of variance in children's sleep quality ratings after controlling for disease severity and active joint count Indicating that increased pain and less positive mood are associated with poor sleep. The interaction between pain and mood did not significantly predict variance in sleep quality. The final model uniquely accounted for 49% of the variance in sleep quality.
These results provide further support for the relationship between pain and sleep in children with arthritis. Furthermore, mood plays a significant role in predicting sleep quality. Health care professionals should assess for sleep difficulties as part of clinical care and future research should investigate longitudinal relationships between pain, sleep, and mood, as well as the impact of sleep difficulties on daily function in children with arthritis.
To cite this abstract, please use the following information:
Bromberg, Maggie Hood, Gil, Karen M., Anthony, Kelly K., Schanberg, Laura E.; Pain and Mood as Predictors of Sleep Quality in Children with Polyarticular Arthritis [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1889