The purpose of the current study was to investigate the influence of sleep
on the relationship between pain
and health care use
(HCU) in youth with sickle cell
disease (SCD). It was hypothesized that poor sleep
would be related to higher HCU and would strengthen the relationship between high pain
frequency and more HCU among youth with SCD.
Materials and Methods:
Ninety-six youth with SCD (aged 8 to 17 y) and their guardians were recruited from 3 regional pediatric SCD clinics. Guardians reported on the youth’s pain
frequency and HCU using the Structured Pain
Interview for parents, and youth wore a sleep
actigraph for up to 2 weeks to assess sleep
duration and sleep
efficiency. A series of regression models were calculated with the following outcomes: emergency department visits, hospitalizations, and health care provider contacts.
Inconsistent with hypotheses, poor sleep
was not directly related to HCU. Also, higher sleep
duration appeared to strengthen the relationship between high pain
frequency and more emergency department visits.
Findings suggest that good sleep
may serve as a protective factor for better matching pain
to HCU. Results should be interpreted in the context of study limitations. Research is needed to investigate possible mechanisms linking sleep
duration to HCU in response to pain
and to ascertain if sleep
patterns influence the relationship between pain
and other functional outcomes in youth with SCD. Clinically, these findings support the need to acknowledge and address the role that sleep
plays in responding to SCD pain
in pediatric populations.