Anesthesiology & Pain Medicine >> Research >> Focus Areas >> Pain Medicine & Neuroscience >> Sleep-Wake Disturbances in Adolescents With Chronic Pain Research
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Research Focus Areas:
Pain Medicine & Neuroscience

Sleep-Wake Disturbances in Adolescents With Chronic Pain Research

Principal Investigators

T. Palermo, Ph.D.


Chronic pain is an important public health issue, affecting as many as 25% of adolescents. Over half of these adolescents report sleep disturbances, such as insomnia, that have the potential to diminish normal daily function, disturb mood, and hinder quality of life. Treatments for sleep problems in pediatric pain populations have not been developed due to lack of knowledge of the specific nature and diagnostic characteristics of these sleep-wake disturbances. The long-term goal of this research program is to develop effective treatments that reduce both chronic pain and sleep disturbances in children and adolescents. The specific aims of this application are to 1) characterize the nature and impact of sleep-wake disturbances experienced by adolescents with chronic pain using subjective survey measures and actigraphy, 2) identify behavioral and psychological factors associated with the pain and sleep relationship, and 3) determine trajectories in sleep-wake disturbances over 12 months. This longitudinal study is composed of three data waves. Time 1 is a cross-sectional comparison of sleep patterns and behaviors, and psychological factors associated with sleep in 240 adolescents, ages 12 to 17 years, (n=60 adolescents with chronic nonmalignant pain, n=60 adolescents with a primary behavioral sleep disorder, n=60 adolescents with major depressive disorder, and n=60 otherwise healthy adolescent peers). Subjective and objective assessment of sleep will be conducted. Ambulatory actigraphy recordings will be completed over 10 days and adolescents will complete subjective sleep measures and an electronic sleep and behavior diary. Behavioral assessment will include a psychiatric screening interview, symptom inventories, and a measure of pre-sleep arousal. Time 2 and Time 3 data waves will occur at 6 and 12 months post study-entry. Repeated assessments of sleep, pain, and behavioral factors will be conducted to examine predictors of sleep disturbances over time. In addition, daily assessment methodology will be used to test a mediation model of the role of depressed mood in the relationship between pain and sleep. Knowledge gained by the proposed studies is expected to positively affect the health of children and adolescents because it will allow the development of new interventions that are designed to decrease pain and sleep disturbances. These advances may ultimately improve the adaptive functioning and quality of life of the substantial population of adolescents affected by chronic pain, and lead to a better understanding of how to prevent the development of disabling, costly pain and sleep problems in adulthood.

Pain Medicine & Neuroscience:
Research Projects

An Internet CBT Intervention for Pediatric Chronic Pain and Disability
T. Palermo, Ph.D.
Cervical Sympathetic Block in Patients with Cerebral Vasospasm following Aneurysmal Subarachnoid Hemmorhage
M. DePinto, M.D., M.M. Treggiari, M.D., Ph.D., M.P.H.
Controlling Pain After Trauma
D. Patterson, Ph.D., S. R. Sharar, M.D., M. Jensen, Ph.D., H. Hoffman, Ph.D., et al.
Cytokine and Neurotransmitter Interactions in Sleep Regulation
M. R. Opp, Ph.D., L. Imeri, M.D.
Disability from Pediatric Traumatic Brain Injury
P Rivara, M.D., M. S. Vavilala, M.D.
Drug Interactions at the Human Blood-Brain Barrier
J. D. Unadkat, Ph.D., K. B. Domino, M.D., M.P.H., A. Collier, M.D., et al.
Effectiveness of Oxymorphone for Acute Postoperative Pain Pediatric Subjects
S.Bhananker, M.D.
Identifying Virtual Reality Analgesia Mechanisms by Pharmacologic Manipulation
S. R. Sharar, M. D., D.A. Patterson, Ph.D, H.Hunter, Ph.D., et al.
Influence of Dexmedetomidine on the Evoked Potentials During Spine Surgery
Rozet, M.D.
Innovations In Pediatric Pain Research
T. Palermo, Ph.D.
Ketorolac in Surgical Infants: Pharmacokinetics/Analgesia
A.M. Lynn, M.D.
Mechanism Of Action Of Volatile Anesthetics
P.G. Morgan, M.D.
Memantine for Post-Operative Pain Control in the Opiate-Tolerant Patient
G. Terman, M.D., Ph.D.
Modulation of Pruritus by Spinal Cannabinoids
G. W. Terman, M.D.,Ph.D.
Molecular Mechanisms of Sleep Responses to Viral Infection
James Krueger, PhD (WSU: PI); Mark R. Opp, PhD (co-investigator/subcontract PI)
Neonatal Pain, Depression and Pain Susceptibility at Maturity in Rats
Gayle Page, DNSc, RN (Johns Hopkins: PI); Mark R. Opp, PhD (co-investigator/subcontract PI)
Neurologic Injury after Non-Supine Surgery Registry
L. A. Lee, M.D., L. Stephens, Ph.D., K. B. Domino, M.D., M.P.H., K. L. Posner, Ph.D.
Neuron-glial communication and brain aging
Paula Bickford, PhD (University of South Florida: PI); Carmelina Gemma, PhD (co-investigator/subcontract PI)
Neuronal-Glial Dialogue and Cognition
Carmelina Gemma, PhD (PI)
Neurotoxic Effects of Volatile Anesthetics in C. Elegans
P.G. Morgan, M.D.
Open Label Study of the Safety and Efficacy of Conivaptan (Vaprisol) to raise serum sodium levels in patients with severe traumatic brain injury
M. M. Treggiari, M.D., Ph.D., M.P.H., S. A. Deem, M.D., N.D. Yanez III, Ph.D.
Optimizing the Control of Pain from Severe Burns
D. Patterson, Ph.D.; S R. Sharar, MD; D. Heimbach, MD., J Doctor, Ph.D.
Patient Perceptions of the Benefits of Long-Term Opioid Therapy (PLOT) Initiative-Beliefs and Behaviors
D. C. Turk, Ph.D., J. P. Robinson., M.D., R. Landau, M.D.
Sepsis Outcomes and Aging: Role of Sleep Disruption and the Blood Brain Barrier
Mark R. Opp, PhD (PI); William A. Banks, MD (co-investigator); Richard M. Raymond, PhD (co-investigator)
Shared Decision Making in Orthopaedic Spine Surgery to Improve Patient Safety
K. B. Domino,M.D, M.P.H.; K. L. Posner, Ph.D. et al.
Sleep-Wake Disturbances in Adolescents with Chronic Pain Research
T. Palermo, Ph.D.
Subgroups of FMS: Symptoms, Beliefs & Tailored Treatments
D.C. Turk, Ph.D., J. Robinson, M.D., Ph.D.
Subjective and Neuroimaging Assessment of Combined Opioid and Virtual Reality Analgesia
S. R. Sharar, M.D., T. Richards, Ph.D.
Ultrasound Guided Rectus Sheath Block for Post-Operative Pain Control Following Umbilical Hernia Repair
S. Flack, M.D.
University of Washington Urologic Chronic Pelvic Pain Syndromes Discovery Center
D. S. Buchwald, M.D., N. Jimenez, M. D., et al.
Web-based CBT for Opioid-treated Chronic Pain Patients With Aberrant Behavior
Rosenblum, Ph.D., D.C. Turk, Ph.D.