Temporal Daily Relationships Between Sleep and Pain in Adolescents With Systemic Lupus Erythematosus.
Dahee Wi, Tonya M Palermo, Elaine Walsh and 1 others
PMID 38149951WHAT IT FOUND
In adolescents with SLE, nights when they slept less than usual were followed by higher next-day morning pain.
Evening pain did not predict next-day sleep duration or efficiency. Low pain and pilot data limit certainty.
Key findings
01A shorter-than-usual night was associated with higher next-day morning pain; each additional hour of sleep was associated with a 0.2 reduction in next-day pain intensity.
02Poorer self-reported sleep quality on average was associated with higher next-day morning pain, but day-to-day changes in sleep quality did not predict next-day pain.
03Evening pain was associated with poorer self-reported sleep quality on average, but not with next-day total sleep time or sleep efficiency, and daily evening pain did not predict next-day sleep.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a pilot study with 23 enrolled adolescent-caregiver dyads, and 3 dyads were excluded for insufficient actigraphy or diary data, so the results rest on a small sample. Average pain was low (1.5 in the morning and 1.4 in the evening on a 0 to 10 scale), and day-to-day pain variability may have been limited. Many adolescents took prescribed medications: 91.3% took immunosuppressants, 47.8% took corticosteroids, and 21.7% took anti-inflammatory medication, but the analyses used only the number of prescribed medications, not medication types. Depression, anxiety, family environment, stress, pain frequency, pain location, pain duration, and pain impact were not measured, so they could influence the sleep-pain links. Five adolescents were recruited after the World Health Organization declared the COVID-19 pandemic, which may have affected sleep. Actigraphy has high agreement to detect sleep and lower agreement to detect wake compared with polysomnography or videosomnography.
Declared interests
The author declared no conflict of interest related to the manuscript. The article is listed as supported by NIH extramural research and non-U.S. government research support.
The easy way to misread this
Do not conclude that increasing sleep will reduce pain in adolescents with SLE. This was a small pilot study with low pain intensity and no sleep treatment, so it reports daily associations rather than a proven effect of more sleep.