Efficacy of psychological interventions on sleep in children and adolescents with chronic pain: a systematic review with meta-analysis of randomized controlled trials.

IF 3.5 3区医学 Q1 CLINICAL NEUROLOGY

Journal of Clinical Sleep Medicine Pub Date : 2025-03-25 DOI:10.5664/jcsm.11678

Tanya L Thwaite, Emma A Craige, Niamh Mundell, Daniel L Belavy, Scott D Tagliaferri, Kate Vincent, Sally A Ferguson, Madeline Sprajcer, Patrick J Owen, Grace E Vincent

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引用次数: 0

Abstract

Study objectives: Chronic pain and comorbid sleep difficulties impacts many children and adolescents. This study aimed to evaluate the efficacy of psychological interventions on sleep in children and adolescents with chronic pain.

Methods: Five databases (PubMed, CINAHL, APA PsychInfo, Embase, CENTRAL) were searched from inception to 17 April 2023 for randomized controlled trials examining the effects of psychological interventions on sleep in participants aged ≤19 years with pain persisting for ≥12 weeks. Six studies (participants, n = 686; 78.43% female) were included. Cochrane risk-of-bias 2 and GRADE were employed.

Results: Pairwise random-effects restricted maximum likelihood meta-analysis demonstrated no effect of psychological interventions on sleep (g [95%CI]: -0.04 [-0.19, 0.11], p = .613, GRADE: high), pain intensity (0.05 [-0.17, 0.27], p = .563, GRADE: high), depressive symptomatology (0.17 [-0.27, 0.62], p = .304, GRADE: moderate) or anxious symptomatology (g [95%CI]: 0.13 [-0.32, 0.57], p = .351, GRADE: moderate). Subjective outcomes may limit clinical utility, and risk of bias (some concern for all studies) decreased confidence in effect estimates.

Conclusions: Development and evaluation of psychological interventions specifically tailored to address comorbidities of sleep difficulties in child and adolescent chronic pain populations is warranted. Systematic Review Registration: Registry: PROSPERO; Identifier: CRD42023454620.

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研究目的：慢性疼痛和合并睡眠困难影响着许多儿童和青少年。本研究旨在评估心理干预对患有慢性疼痛的儿童和青少年睡眠的疗效：在五个数据库（PubMed、CINAHL、APA PsychInfo、Embase、CENTRAL）中搜索了从开始到2023年4月17日的随机对照试验，研究心理干预对年龄≤19岁、疼痛持续时间≥12周的参与者睡眠的影响。共纳入六项研究（参与者人数=686；78.43%为女性）。采用了 Cochrane 偏倚风险 2 和 GRADE：配对随机效应限制最大似然法荟萃分析表明，心理干预对睡眠（g [95%CI]: -0.04 [-0.19, 0.11]，p = .613，GRADE：高）、疼痛强度（0.05 [-0.17, 0.27], p = .563, GRADE：高）、抑郁症状（0.17 [-0.27, 0.62], p = .304, GRADE：中度）或焦虑症状（g [95%CI]: 0.13 [-0.32, 0.57], p = .351, GRADE：中度）。主观结果可能会限制临床实用性，而偏倚风险（所有研究都存在）降低了对效果估计值的信心：结论：有必要开发和评估专门针对儿童和青少年慢性疼痛人群睡眠障碍合并症的心理干预措施。系统综述注册：注册表：PROSPERO; Identifier：CRD42023454620。

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来源期刊

Journal of Clinical Sleep Medicine CLINICAL NEUROLOGY-

CiteScore

6.20

自引率

7.00%

发文量

321

审稿时长

1 months

期刊介绍： Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.