The Unfavorable Alliance of Pain and Poor Sleep in Children with Life-Limiting Conditions and Severe Psychomotor Impairment
Abstract
:1. Introduction
2. Materials and Methods
2.1. Dataset
- Child is affected by intellectual disability and at least one additional physical disability;
- Parents/caregivers are able to adequately communicate in German;
- Patient is being cared for in one of the participating institutions;
- Parents consented to participation and the use of the patient’s data for study purposes [4].
2.2. Sleep Questionnaire for Children with Severe Psychomotor Impairment (SNAKE)
2.3. Child- and Environment-Related Factors
2.4. Statistical Analyses
3. Results
3.1. Sample Characteristics
3.2. Frequency of CRF and ERF
3.3. Influence of CRF and ERF on the Global Ratings of Children’s Sleep
3.4. Influence of CRF and ERF on the SNAKE Scales
3.5. Influence of CRF and ERF on Sleep Duration and Sleep Efficacy
4. Discussion
4.1. Child-Related Factors and their Influence on Sleep
4.2. Environment-Related Factors and their Influence on Sleep
4.3. Clinical Implications
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Drug Class 1 | Active Agent | N |
---|---|---|
Non-opioid analgesics | Dipyrone | 8 |
Ibuprofen | 2 | |
Acetylsalicylic acid | 2 | |
Paracetamol | 2 | |
Weak opioids | Tilidine | 2 |
Strong opioids | Morphine | 4 |
Opium tincture | 1 | |
Oxycodone | 1 | |
Cannabinoids | Delta-9-Tetrahydrocannabinol | 1 |
23 |
Dependant Variables: SNAKE Scales 1–5 | ||||||||||||||||
Scale 1 (Disturbances Going to Sleep) | Scale 2 (Disturbances Remaining Asleep) | Scale 3 (Arousal and Breathing Disorders) | Scale 4 (Daytime Sleepiness) | Scale 5 (Daytime Behaviour Disorders) | ||||||||||||
Variable | B (SE) | β | t | B (SE) | β | t | B (SE) | β | t | B (SE) | β | t | B (SE) | β | t | |
CRF | Pain | 3.10 (0.71) | 0.36 | 4.33 *** | 2.76 (0.74) | 0.28 | 3.70 *** | 2.43 (0.69) | 0.26 | 3.51 ** | 0.24 (0.47) | 0.04 | 0.50 | 1.76 (0.66) | 0.23 | 2.66 ** |
Repositioning | 0.12 (0.69) | 0.01 | 0.17 | 2.16 (0.72) | 0.22 | 2.98 ** | 2.66 (0.67) | 0.29 | 3.95 *** | 0.98 (0.46) | 0.16 | 2.13 * | 0.08 (0.64) | 0.01 | 0.13 | |
Epilepsy | −0.81 (0.69) | −0.08 | −1.17 | 1.70 (0.72) | 0.16 | 2.34 * | 0.77 (0.67) | 0.07 | 1.15 | 2.36 (0.46) | 0.37 | 5.13 *** | 0.59 (0.65) | 0.07 | 0.90 | |
Medical care | 0.86 (1.02) | 0.06 | 0.84 | −0.03 (1.06) | −0.00 | −0.03 | 0.51 (0.98) | 0.03 | 0.52 | −0.34 (0.67) | −0.03 | −0.50 | −0.00 (0.93) | −0.00 | −0.00 | |
ERF | Noise | −0.16 (0.82) | −0.01 | −0.19 | −0.16 (0.85) | −0.01 | −0.18 | 1.10 (0.79) | 0.09 | 1.38 | 0.51 (0.54) | 0.06 | 0.94 | 0.98 (0.75) | 0.10 | 1.30 |
TV/Radio | −0.19 (0.85) | −0.01 | −0.23 | 0.83 (0.88) | 0.06 | 0.94 | −1.09 (0.82) | −0.08 | −1.32 | 23 (0.56) | 0.02 | 0.41 | 0.13 (0.78) | 0.01 | 0.17 | |
Lights on | 0.58 (0.68) | 0.06 | 0.84 | 0.90 (0.71) | 0.09 | 1.27 | 0.47 (0.66) | 0.05 | 0.71 | 0.76 (0.45) | 0.12 | 1.66 | 0.01 (0.63) | 0.00 | 0.02 | |
Door open | 0.95 (0.61) | 0.11 | 1.54 | 0.23 (0.64) | 0.02 | 0.36 | 0.22 (0.59) | 0.02 | 0.37 | −0.13 (0.40) | −0.02 | −0.33 | 0.15 (0.57) | 0.02 | 0.26 | |
Dependant Variables: Sleep Duration and Sleep Efficacy | ||||||||||||||||
Sleep Duration | Sleep Efficacy | |||||||||||||||
Variable | B (SE) | β | t | B (SE) | β | t | ||||||||||
CRF | Pain | −0.56 (0.35) | −0.14 | −1.58 | −3.98 (3.25) | −0.11 | −1.22 | |||||||||
Repositioning | −0.74 (0.34) | −0.18 | −2.15 * | −7.49 (3.19) | −0.21 | −2.34 * | ||||||||||
Epilepsy | −0.38 (0.34) | −0.08 | −1.11 | −8.53 (3.14) | −0.22 | −2.71 * | ||||||||||
Medical care | 0.66 (0.50) | 0.10 | 1.31 | 5.25 (4.40) | 0.10 | 1.19 | ||||||||||
ERF | Noise | 0.40 (0.40) | 0.07 | 1.01 | 5.35 (3.51) | 0.12 | 1.52 | |||||||||
TV/Radio | −0.32 (0.41) | −0.06 | −0.78 | −4.29 (3.78) | −0.09 | −1.13 | ||||||||||
Lights on | −0.36 (0.33) | −0.08 | −1.07 | −2.89 (3.05) | −0.08 | −0.94 | ||||||||||
Door open | −0.16 (0.30) | −0.04 | −0.54 | 1.82 (2.74) | 0.05 | 0.66 |
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Dreier, L.A.; Wager, J.; Blankenburg, M.; Zernikow, B. The Unfavorable Alliance of Pain and Poor Sleep in Children with Life-Limiting Conditions and Severe Psychomotor Impairment. Children 2018, 5, 82. https://doi.org/10.3390/children5070082
Dreier LA, Wager J, Blankenburg M, Zernikow B. The Unfavorable Alliance of Pain and Poor Sleep in Children with Life-Limiting Conditions and Severe Psychomotor Impairment. Children. 2018; 5(7):82. https://doi.org/10.3390/children5070082
Chicago/Turabian StyleDreier, Larissa Alice, Julia Wager, Markus Blankenburg, and Boris Zernikow. 2018. "The Unfavorable Alliance of Pain and Poor Sleep in Children with Life-Limiting Conditions and Severe Psychomotor Impairment" Children 5, no. 7: 82. https://doi.org/10.3390/children5070082