Journal Article

Lengthening sleep reduces pain in childhood arthritis: a crossover randomised controlled trial

Cameron, Bonnie, Paetkau, Susan, Spiegel, Lynn, Stephens, Samantha, Dover, Saunya, Tomlinson, George, Clairman, Hayyah, Stinson, Jennifer, Tse, Shirley, Whitney, Kristi, Narang, Indra, Feldman, Brian M, Schneider, Rayfel, Weiss, Shelly, Beebe, Dean, Levy, Deborah, Laxer, Ronald M

2023

Overview

ObjectivesJuvenile idiopathic arthritis (JIA) is a common chronic childhood disease and chronic pain is a debilitating feature. A strong link has been shown between poor sleep and pain in JIA. However, the causal direction is unknown. This study’s aim was to determine if, in adolescents with JIA, a recommended healthful sleep duration leads to reductions in pain when compared with the restricted sleep (RS) duration that is commonly seen.MethodsPatients with JIA (12–18 years old; pain score of ≥1 on a visual analogue scale) participated in a randomised, crossover sleep manipulation protocol. The 3-week protocol comprised a baseline week (BL), a week with healthy sleep duration (HSD; 9.5 hours in bed/night) and a RS week (RS; 6.5 hours in bed/night). After BL, participants were randomly assigned to either HSD or RS, and then crossed over to the other condition. Pain was self-assessed using the iCanCope with Pain app. We used Bayesian hierarchical models to estimate the effect of sleep duration on pain.ResultsParticipants (n=31; mean age=15.0±1.8 years) averaged 1.4 (95% credible interval (CrI) 1.2–1.6) more hours of sleep per night during HSD relative to RS. Compared with RS, HSD resulted in a favourable effect on pain scores (OR 0.61, 95% CrI 0.39–0.95).ConclusionIt is possible to have adolescents with childhood arthritis get a healthier sleep duration, and this longer sleep results in reduced pain. These findings complement prior correlational studies and confirm a causal relationship between reduced sleep duration and increased pain.Trial registration numberNCT04133662.

• Publisher: EULAR,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Age groups / Arthritis / arthritis, juvenile / Caffeine / Chronic illnesses / COVID-19 / Fatigue / Paediatric Rheumatology / Pain / Pandemics / patient reported outcome measures / Pediatrics / Rheumatology / Sleep apnea / Teenagers